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Montana rates for HCPCS A4714

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

Facilitymedian $2 · 10th–90th $2–$40%50%10th90th$2Professionalmedian $2 · 10th–90th $2–$20%50%90th$2$1.0$2.0$5.0$10.0$20.0$50.0

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
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $64.57
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.14 / $4.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $35.48 / $35.48