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Missouri rates for HCPCS A4720

Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis

Facilitymedian $21 · 10th–90th $19–$460%20%40%10th90th$21Professionalmedian $19 · 10th–90th $15–$190%50%10th$19$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
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $20.42 / $43.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50