go back

Mississippi rates for HCPCS A4714

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.99 / $13.99 / $13.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $21.25 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.39 / $30.03 / $50.36