go back

Oregon 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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $177.83
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $281.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $281.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $79.43 / $79.43