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Utah rates for HCPCS A4714

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

Facilitymedian $2 · 10th–90th $2–$20%50%100%$2Professionalmedian $2 · 10th–90th $2–$20%50%$2$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. Small sample — interpret with caution. 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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $35.48 / $58.88