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Montana rates for HCPCS A4765

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

Facilitymedian $6 · 10th–90th $5–$4570%20%40%10th90th$6Professionalmedian $5 · 10th–90th $5–$2820%50%90th$5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $281.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.89 / $457.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11