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Sterile Water, Saline or Dextrose Diluent or Flush

Pennsylvania rates for HCPCS A4216

Sterile water, saline and/or dextrose, diluent/flush, 10 ml

Rates data updated July 2026.

Facilitymedian $6 · 10th–90th $0$6610%10%10th90th$6Professionalmedian $0 · 10th–90th $0$10%20%10th90th$0$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.38
Median
$5.62
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.17
Median
$0.35
Typical High
$0.50
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$46.77
Typical High
$63.10
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$407.38
Typical High
$724.44
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$0.40
Median
$0.40
Typical High
$0.40
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$0.62
Median
$0.62
Typical High
$0.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.37
Median
$0.81
Typical High
$0.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.31
Median
$0.31
Typical High
$0.31
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$0.62
Median
$0.83
Typical High
$1.20
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$0.63
Median
$0.63
Typical High
$0.63
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$0.38
Median
$0.44
Typical High
$0.63
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.62
Median
$6.03
Typical High
$8.71
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$407.38
Typical High
$794.33
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$0.38
Median
$5.62
Typical High
$251.19
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$0.17
Median
$0.34
Typical High
$0.51
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$0.59
Median
$2.24
Typical High
$3.89
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$0.50
Median
$0.52
Typical High
$0.60
United
Setting
Professional
Modifier
Global
Typical Low
$0.24
Median
$0.31
Typical High
$0.72