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Peritoneal Dialysate Concentrate, Powder Additive

Mississippi rates for HCPCS A4765

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

Rates data updated July 2026.

Facilitymedian $282 · 10th–90th $282$2820%50%100%$282Professionalmedian $5 · 10th–90th $5$2820%50%90th$5$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$25.12
Typical High
$67.61