Peritoneal dialysis solution, 3000 mL bag

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Dialys sol fld vol > 2999cc

Payers reporting HCPCS A4723

Payer pricing summary

Low

Average

$117

Median

$37

High

$941

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +11 other terms	39	$43	$69	$48	71%	—	$21 – $225
2	Cigna percent of total billed charges · outpatientfrom % of charges · +5 other terms	34	$72	$316	$355	112%	—	$3 – $3.6k
3	MultiPlan percent of total billed charges · outpatientfrom % of charges · +5 other terms	33	$75	$89	$108	122%	—	$10 – $700
4	Blue Cross Blue Shield facility · fee schedule · outpatient · +8 other terms	32	$22	$24	$19	79%	—	$0 – $61
5	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	24	$9	$63	$66	104%	—	$2 – $313
6	Anthem facility · case rate · outpatient · +7 other terms	15	$15	$17	$4	23%	—	$10 – $26
7	Caresource facility · case rate · outpatient · +2 other terms	15	$16	$17	$4	23%	—	$10 – $27
8	Molina facility · case rate · outpatient · +3 other terms	15	$15	$17	$4	23%	—	$11 – $26
9	UnitedHealthcare facility · case rate · outpatient · +8 other terms	15	$16	$17	$4	23%	—	$11 – $27
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$75	$48	$41	87%	—	$0 – $94
11	Optum facility · case rate · outpatient · +2 other terms	11	$14	$16	$4	22%	—	$13 – $24
12	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	10	$323	$437	$307	70%	—	$165 – $1.5k
13	Medica fee schedule · both · +2 other terms	9	$37	$37	—	—	—	$37 – $37
14	Ucare fee schedule · both	9	$38	$38	$2	5%	—	$36 – $40
15	WellCare percent of total billed charges · outpatientfrom % of charges	9	$34	$35	$30	84%	—	$3 – $118
16	Aetna Better Health fee schedule · inpatient · +3 other terms	7	$36	$36	—	—	—	$36 – $36
17	Ambetter percent of total billed charges · outpatientfrom % of charges · +1 other terms	7	$5	$32	$55	174%	—	$5 – $177
18	Highmark facility · percent of total billed charges · outpatientfrom % of charges	7	$103	$135	$197	145%	—	$18 – $1.1k
19	Medcost percent of total billed charges · outpatientfrom % of charges	7	$119	$109	$28	25%	—	$76 – $167
20	Amerihealth Caritas percent of total billed charges · outpatientfrom % of charges · +1 other terms	5	$71	$79	$17	22%	—	$62 – $120
21	Excellus facility · fee schedule · outpatient	5	$1	$2	$2	101%	—	$0 – $6
22	Humana fee schedule · inpatient · +6 other terms	5	$35	$35	—	—	—	$35 – $35
23	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$17	$18	$1	6%	—	$17 – $19
24	Beechstreet percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$14	$14	—	—	—	$14 – $14
25	First Health professional · fee schedule · both · +4 other terms	3	$39	$39	—	—	—	$39 – $39

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