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Maryland rates for HCPCS G0491

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.59 / $1,060.57 / $1,060.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $500.00 / $700.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.81 / $1.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.00 / $585.00 / $585.00