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Wisconsin rates for HCPCS A4760

Dialysate solution test kit, for peritoneal dialysis, any type, each

Facilitymedian $25 · 10th–90th $24–$370%50%10th90th$25Professionalmedian $24 · 10th–90th $24–$360%50%90th$24$1.0$5.0$20.0$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
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.19
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $36.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $162.18 / $213.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $36.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $0.89
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
$0.89 / $0.89 / $0.89