go back

Maine rates for HCPCS A4726

Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $34.67 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $20.42 / $28.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $34.67 / $41.69