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Peritoneal Dialysate Concentrate, Powder Additive

Florida rates for HCPCS A4765

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

Rates data updated July 2026.

Facilitymedian $5 · 10th–90th $5$50%50%$5Professionalmedian $5 · 10th–90th $5$160%50%90th$5$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$6.46
AvMed
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$39.81
Typical High
$50.12
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$44.67
Typical High
$38,018.94
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$0.68
Median
$0.68
Typical High
$0.68