go back

Texas rates for HCPCS A4765

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

Facilitymedian $6 · 10th–90th $5$2820%20%40%10th90th$6Professionalmedian $5 · 10th–90th $5$50%50%90th$5$1.0$5.0$20.0$100.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$6.03
Typical High
$6.03
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$19.50
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$0.60
Median
$0.60
Typical High
$0.60
Providence
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.62
Typical High
$281.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$79.43
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$0.68
Median
$0.68
Typical High
$0.85