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Missouri 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
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.78 / $507.03 / $709.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $60.69 / $79.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.00 / $1,020.00 / $1,020.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,060.57 / $1,145.42 / $2,216.59