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Missouri rates for HCPCS A4724

Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis

Facilitymedian $20 · 10th–90th $19–$430%20%40%10th90th$20Professionalmedian $18 · 10th–90th $14–$190%50%10th90th$18$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $18.20 / $18.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $23.44 / $30.20
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
$18.62 / $19.95 / $42.66