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Wisconsin rates for HCPCS A4707

Bicarbonate concentrate, powder, for hemodialysis, per packet

Facilitymedian $5 · 10th–90th $4–$70%50%10th90th$5Professionalmedian $5 · 10th–90th $4–$50%50%10th$5$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $5.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $6.46
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $5.13 / $6.17
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $33.11 / $43.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $5.13 / $7.24
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $5.75
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $5.75