go back

Peritoneal Dialysate Concentrate, Powder Additive

Oklahoma rates for HCPCS A4765

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

Rates data updated July 2026.

How much rates vary

Facilitymedian $5 · 10th to 90th $5 to $7Professionalmedian $5 · 10th to 90th $5 to $282
$10$20$50$100$200facility $5professional $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
$5.50
Typical High
$6.61