go back

South Dakota 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
$35.00 / $35.00 / $35.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.91 / $59.15 / $95.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.21