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Missouri rates for HCPCS A4765

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

Facilitymedian $6 · 10th–90th $5–$130%20%40%10th90th$6Professionalmedian $5 · 10th–90th $5–$50%50%$5$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
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $2.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.89 / $12.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03