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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
$31.50 / $31.50 / $31.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.99 / $13.99 / $13.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.43 / $33.64 / $47.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.43 / $33.64 / $47.38