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Peritoneal Dialysate Concentrate, Powder Additive

Louisiana rates for HCPCS A4765

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

Rates data updated October 2026.

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $0Professionalmedian $5 · 10th to 90th $5 to $5
$0.1$1$10$100facility $0professional $5

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Aetna
Setting
Professional
Modifier
None
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.81
Median
$0.81
Typical High
$0.81
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.55
Median
$0.55
Typical High
$0.55
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$0.02
Median
$0.02
Typical High
$0.03