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Illinois rates for HCPCS A4722

Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis

Facilitymedian $74 · 10th–90th $35–$1000%50%10th90th$74Professionalmedian $35 · 10th–90th $35–$350%50%$35$20.0$100.0$500.0$2.0K$10.0K

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
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $44.67 / $38,018.94