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Minnesota 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 / $993.59 / $1,060.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.66 / $101.66 / $793.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.67 / $98.61 / $101.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$917.98 / $1,060.57 / $1,792.36