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Montana rates for HCPCS A4766

Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml

Facilitymedian $4 · 10th–90th $4–$560%20%40%10th90th$4Professionalmedian $3 · 10th–90th $3–$350%50%90th$3$5.0$10.0$20.0$50.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $34.67
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $4.17 / $56.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11