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Peritoneal Dialysis Physician Evaluation (Per Day)

Pennsylvania rates for HCPCS 90947

A physician's evaluation of a patient receiving a dialysis treatment method other than standard hemodialysis, most often peritoneal dialysis, billed for a single day rather than as part of a monthly bundle. It reflects multiple evaluations by the physician during that day's dialysis-related care, rather than just one.

Rates data updated July 2026.

How much does Peritoneal Dialysis Physician Evaluation (Per Day) cost?

$126

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $1,072 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 11 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$117 to $145
FacilityA hospital or hospital-owned outpatient department$1,072$575 to $1,445

How much rates vary

Facilitymedian $1,072 · 10th to 90th $138 to $1,905Professionalmedian $126 · 10th to 90th $107 to $214
$100$200$500$1K$2Kfacility $1,072professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$123.03
Typical High
$213.80
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$120.23
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$125.89
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$144.54
Typical High
$251.19
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$223.87
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$169.82
Typical High
$257.04
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$128.82
Typical High
$204.17
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$125.89
Typical High
$257.04
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$169.82
Typical High
$263.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,230.27
Typical High
$1,905.46
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$120.23
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$131.83
Typical High
$229.09

Where Pennsylvania sits

The same service costs 2.2 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 41st of 51

$126

MN $263WV $120

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.