go back

Nebraska rates for HCPCS A4765

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $281.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $8.51 / $281.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03