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Kansas rates for HCPCS A4714

Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $14.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.04 / $2.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $33.88 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $33.88 / $47.86