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
$33
Average
$78
Median
$33
High
$586
Each hospital's average Medica rate, under the methodology and billing class chosen below.
13 hospitals; the 90th percentile is 1.8× 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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13 hospital rates
iThe hospitals that file a Medica 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 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 2 | Fairview Health Services Edina, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 3 | Fairview Health Services Minneapolis, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 4 | Fairview Health Services Burnsville, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 5 | Fairview Health Services Wyoming, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 6 | Fairview Health Services Princeton, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 7 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 2 | $33 | $33 | — | — | — | $33 – $33 |
| 8 | Grand Itasca Clinic and Hospital Grand Rapids, MN professional · fee schedule · both | 3 | $33 | $33 | — | — | — | $33 – $33 |
| 9 | HCA FLORIDA JFK NORTH HOSPITAL West Palm Beach, FL percent of total billed charges · outpatientfrom % of charges | 1 | $586 | $586 | $3 | 1% | — | $582 – $589 |
| 10 | HealthEast St John's Hospital Maplewood, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 11 | HealthEast Woodwinds Hospital Woodbury, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 12 | Methodist Hospital St. Louis Park, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $72 | $68 | $48 | 70% | — | $7 – $140 |
| 13 | Range Regional Health Services Hibbing, MN professional · fee schedule · both | 2 | $33 | $33 | — | — | — | $33 – $33 |
← Payers reporting HCPCS A4722 · Snapshot 20261111T120946Z-9134e7f7