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Pennsylvania rates for HCPCS A4714

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

Facilitymedian $3 · 10th–90th $3–$30%50%$3Professionalmedian $2 · 10th–90th $2–$320%50%90th$2$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $2.51 / $2.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $66.07 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $27.54
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $35.48 / $61.66