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Wisconsin rates for HCPCS A4766

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

Facilitymedian $4 · 10th–90th $4–$60%50%90th$4Professionalmedian $3 · 10th–90th $3–$40%50%90th$3$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $30.20 / $33.11
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $5.37
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $5.75
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $3.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $3.72