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Pennsylvania 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

Facilitymedian $45 · 10th–90th $35–$450%50%10th$45Professionalmedian $35 · 10th–90th $35–$350%50%$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
$44.67 / $44.67 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $18.62
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $30.20