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Michigan 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 $35 · 10th–90th $2–$350%50%10th$35Professionalmedian $35 · 10th–90th $26–$350%50%10th$35$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. 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
$8.13 / $8.13 / $8.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.51
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.14 / $34.67
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $34.67 / $34.67