HCPCS A4721
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Current codePeritoneal Dialysis7 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1.24 | — | — |
| Providence Holy Family Hospital | $1.24 | — | — |
| Providence Regional Medical Center Everett | $1.24 | — | — |
| Swedish Edmonds Hospital | $1.24 | — | — |
| Swedish Issaquah | $1.24 | — | — |
| Swedish Medical Center | $1.24 | — | — |
| Swedish Medical Center / Cherry Hill | $1.24 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.