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Ohio 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
$1,281.58 / $1,281.58 / $1,281.58
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 / $558.00 / $558.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.27 / $67.26 / $104.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.35 / $501.97 / $565.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.00 / $530.00 / $700.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.00 / $593.00 / $700.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00