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Missouri 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 $38 · 10th–90th $35–$780%20%40%10th90th$38Professionalmedian $35 · 10th–90th $20–$350%50%10th$35$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
$34.67 / $34.67 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $23.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $37.15 / $77.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70