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Florida rates for HCPCS G0491

Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$993.59 / $993.59 / $993.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.98 / $993.59 / $1,060.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $300.00 / $353.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $50.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.26 / $78.26 / $78.26