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Texas rates for HCPCS A4714

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

Facilitymedian $2 · 10th–90th $2–$40%50%90th$2Professionalmedian $2 · 10th–90th $2–$520%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $120.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $4.27
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $4.27
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $29.51 / $29.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $33.11 / $61.66
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.51