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Kentucky 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
$1,060.57 / $1,060.57 / $1,060.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.77 / $1,060.57 / $1,060.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541.00 / $541.00 / $541.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $60.00 / $70.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $300.00 / $300.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.00 / $446.00 / $446.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $3,000.00