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Dialysis access (AV fistula) in Pennsylvania: what insurers pay

Posted commercial rates at 5 Pennsylvania hospitals, each next to its own Medicare base rate.

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CPT 36821

HospitalMedian across insurers× MedicareInsurersFile date
Riddle Memorial Hospital Media$4,4201.4×22026-04-01
Bryn Mawr Hospital Bryn Mawr$4,6421.4×22026-04-01
Upmc Presbyterian Shadyside Pittsburgh$5,0311.6×12026-03-06
Thomas Jefferson University Hospital Philadelphia$9,1722.8×32026-09-15
Lehigh Valley Hospital Allentown$11,8313.7×82026-07-01

CPT 36818

HospitalMedian across insurers× MedicareInsurersFile date
Riddle Memorial Hospital Media$5,4010.9×22026-04-01
Bryn Mawr Hospital Bryn Mawr$5,7601.0×22026-04-01
Upmc Presbyterian Shadyside Pittsburgh$7,8591.4×12026-03-06
Thomas Jefferson University Hospital Philadelphia$9,1721.6×32026-09-15
Lehigh Valley Hospital Allentown$13,9792.5×82026-07-01

Questions

How much do insurers pay for dialysis access (av fistula) in Pennsylvania?

5 Pennsylvania hospitals post usable commercial rates for dialysis access (av fistula) in their federal price-transparency files. For CPT 36821, hospital outpatient, the median across 5 hospitals is $5,031, 1.6× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.