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Wisconsin 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 $19 · 10th–90th $19–$720%50%90th$19Professionalmedian $18 · 10th–90th $4–$220%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
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $18.20 / $18.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $30.20 / $33.11
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $25.70
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $128.82 / $169.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $27.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44