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Dialysate, over 4999 to 5999 cc, for Peritoneal Dialysis

Montana rates for HCPCS A4725

Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

Rates data updated July 2026.

Facilitymedian $35 · 10th–90th $35$720%50%90th$35Professionalmedian $35 · 10th–90th $35$350%50%$35$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
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Providence
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$72.44
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11