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Peritoneal Dialysate Concentrate, Powder Additive

Nebraska rates for HCPCS A4765

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

Rates data updated July 2026.

How much rates vary

Facilitymedian $9 · 10th to 90th $5 to $11Professionalmedian $5 · 10th to 90th $5 to $282
$5$10$20$50$100$200$500facility $9professional $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
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$281.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$8.51
Typical High
$10.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$6.03