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Connecticut rates for HCPCS A4721

Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis

Professionalmedian $20 · 10th–90th $20–$200%50%$20$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$19.95 / $19.95 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $12.30 / $30.20
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64,565.42 / $64,565.42 / $64,565.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $38,018.94