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Peritoneal Dialysate Concentrate, Solution Additive

Wisconsin rates for HCPCS A4766

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

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $4$60%50%90th$4Professionalmedian $4 · 10th–90th $4$40%50%$4$5.0$10.0$20.0$50.0$100.0

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
$3.80
Median
$3.80
Typical High
$3.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$3.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$30.20
Typical High
$33.11
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$5.37
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$5.75
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$3.72
Typical High
$3.72
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$54.95
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$5.37
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Quartz
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$3.72
Typical High
$3.72