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Washington rates for HCPCS 96522

Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.45 / $139.41 / $274.70
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.24 / $274.10 / $1,030.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.79 / $217.19 / $367.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.24 / $196.07 / $304.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.61 / $164.11 / $278.44
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.25 / $269.08 / $330.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.24 / $231.79 / $305.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.73 / $182.23 / $336.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.48 / $130.29 / $130.29