Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L
Low
$4
Average
$132
Median
$81
High
$989
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
193 hospitals; the 90th percentile is 15.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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220 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 2 | $96 | $89 | $62 | 70% | — | $33 – $279 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 3 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $87 | $87 | — | — | — | $87 – $87 |
| 4 | BLUE RIDGE REGIONAL HOSPITAL Spruce Pine, NC percent of total billed charges · outpatientfrom % of charges | 2 | $97 | $95 | $73 | 76% | — | $30 – $313 |
| 5 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 6 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $97 | $97 | $1 | 1% | — | $96 – $98 |
| 7 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 8 | Blue Ridge HealthCare Hospitals, Inc Valdese, NC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $85 | $85 | $6 | 7% | — | $79 – $91 |
| 9 | Blue Ridge HealthCare Hospitals, Inc Valdese, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $53 | $55 | $31 | 57% | — | $22 – $92 |
| 10 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $35 | $45 | $15 | 32% | — | $35 – $66 |
| 11 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 12 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 13 | CAREPARTNERS REHABILITATION HOSPITAL Asheville, NC percent of total billed charges · outpatientfrom % of charges | 8 | $110 | $124 | $69 | 56% | — | $37 – $298 |
| 14 | CHIPPENHAM HOSPITAL RICHMOND, VA percent of total billed charges · outpatientfrom % of charges | 1 | $254 | $254 | $0 | 0% | — | $254 – $254 |
| 15 | CHRISTUS Hospital - Orange Orange, TX percent of total billed charges · outpatientfrom % of charges | 6 | $429 | $389 | $107 | 28% | — | $149 – $475 |
| 16 | CHRISTUS West Beaumont Beaumont, TX percent of total billed charges · outpatientfrom % of charges | 6 | $429 | $389 | $107 | 28% | — | $149 – $475 |
| 17 | Caldwell Memorial Hospital Lenoir, NC facility · percent of total billed charges · outpatientfrom % of charges | 3 | $77 | $84 | $42 | 50% | — | $18 – $181 |
| 18 | Central Georgia Rehabilitation LLC Macon, GA percent of total billed charges · outpatientfrom % of charges | 3 | $8 | $108 | $247 | 229% | — | $6 – $1.0k |
| 19 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 20 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $35 | $35 | — | — | — | $35 – $35 |
| 21 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 22 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 23 | Christus Health Southeast Texas Beaumont, TX percent of total billed charges · outpatientfrom % of charges | 6 | $429 | $389 | $107 | 28% | — | $149 – $475 |
| 24 | Christus Health Southeast Texas Port Arthur, TX percent of total billed charges · outpatientfrom % of charges | 6 | $429 | $389 | $107 | 28% | — | $149 – $475 |
| 25 | Clara Maass Medical Center Belleville, NJ fee schedule · outpatient | 2 | $43 | $43 | — | — | — | $43 – $43 |
← Payers reporting HCPCS A4722 · Snapshot 20261111T120946Z-9134e7f7