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Peritoneal Dialysate Concentrate, Powder Additive

Iowa rates for HCPCS A4765

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

Rates data updated July 2026.

How much rates vary

Facilitymedian $5 · 10th to 90th $5 to $9Professionalmedian $5 · 10th to 90th $5 to $5
$5$10$20$50$100$200facility $5professional $5

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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
$5.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$9.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$6.03