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Wisconsin rates for HCPCS A4726

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

Facilitymedian $35 · 10th–90th $35–$490%50%90th$35Professionalmedian $35 · 10th–90th $35–$350%50%$35$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
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $20.42 / $22.39
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $41.69
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $57.54 / $77.62
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $48.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
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
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18