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Arizona rates for HCPCS A4765

Dialysate concentrate, powder, additive for peritoneal dialysis, per packet

Facilitymedian $11 · 10th–90th $5–$3160%20%10th90th$11Professionalmedian $5 · 10th–90th $5–$60%50%90th$5$5.0$20.0$100.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $10.96 / $21.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $8.91 / $13.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $100.00 / $331.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03