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
DIALYSATE 4.25% INJ
Erie, PA
See all hospitals reporting HCPCS A4722 →Price type
UPMC Hamot’s median price of $92 is 164% above the median hospital's median price ($35), higher than 73% of the 339 hospitals reporting HCPCS A4722. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 24 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $58 | $54 | $23 | 42% | — | $10 – $82 |
| 2 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $62 | $58 | $24 | 42% | — | $11 – $89 |
| 3 | Cigna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges | $69 | $64 | $27 | 42% | — | $12 – $99 |
| 4 | Cigna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $69 | $64 | $27 | 42% | — | $12 – $99 |
| 5 | Cigna new business aso facility · percent of total billed charges · inpatientfrom % of charges | $69 | $64 | $27 | 42% | — | $12 – $99 |
| 6 | Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges | $69 | $64 | $27 | 42% | — | $12 – $99 |
| 7 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $81 | $75 | $32 | 42% | — | $14 – $115 |
| 8 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $92 | $86 | $36 | 42% | — | $16 – $132 |
| 9 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $92 | $86 | $36 | 42% | — | $16 – $132 |
| 10 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $92 | $86 | $36 | 42% | — | $16 – $132 |
| 11 | Cigna ebr facility · percent of total billed charges · inpatientfrom % of charges | $92 | $86 | $36 | 42% | — | $16 – $132 |
| 12 | Cigna ebr facility · percent of total billed charges · outpatientfrom % of charges | $92 | $86 | $36 | 42% | — | $16 – $132 |
| 13 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $105 | $96 | $46 | 48% | — | $18 – $150 |
| 14 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $105 | $105 | — | — | — | $105 – $105 |
| 15 | Highmark commercial - indemnity/commercial - social mission indemnity/managed care/managed care - social mission facility · percent of total billed charges · outpatientfrom % of charges | $113 | $105 | $44 | 42% | — | $20 – $161 |
| 16 | Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $116 | $107 | $45 | 42% | — | $20 – $165 |
| 17 | Highmark medicare facility · percent of total billed charges · outpatientfrom % of charges | $116 | $107 | $45 | 42% | — | $20 – $165 |
| 18 | Aetna axa/mmo facility · percent of total billed charges · inpatientfrom % of charges | $162 | $150 | $63 | 42% | — | $28 – $230 |
| 19 | Aetna axa/mmo facility · percent of total billed charges · outpatientfrom % of charges | $162 | $150 | $63 | 42% | — | $28 – $230 |
| 20 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · inpatientfrom % of charges | $162 | $150 | $63 | 42% | — | $28 – $230 |
| 21 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · outpatientfrom % of charges | $162 | $150 | $63 | 42% | — | $28 – $230 |
| 22 | Highmark upmc emergent facility · percent of total billed charges · outpatientfrom % of charges | $181 | $168 | $71 | 42% | — | $31 – $258 |
| 23 | MultiPlan complimentary network rate (includes multiplan as payer) facility · percent of total billed charges · inpatientfrom % of charges | $185 | $172 | $73 | 42% | — | $32 – $263 |
| 24 | MultiPlan complimentary network rate (includes multiplan as payer) facility · percent of total billed charges · outpatientfrom % of charges | $185 | $172 | $73 | 42% | — | $32 – $263 |
Last updated: Mar 6, 2026
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