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Peritoneal Dialysate Concentrate, Solution Additive

Montana rates for HCPCS A4766

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

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $4$560%20%40%10th90th$4Professionalmedian $4 · 10th–90th $4$350%50%90th$4$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
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$34.67
Providence
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$4.17
Typical High
$56.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11