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Refill Kit for Implantable Infusion Pump

California rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $3$100%20%40%10th90th$4Professionalmedian $20 · 10th–90th $4$200%50%10th$20$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$3,235.94
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.80
Typical High
$9.55
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$3.98
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$3.72
Typical High
$6.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$0.91
Typical High
$0.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$56.23
Typical High
$154.88
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Molina
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$0.91
Typical High
$0.91
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
United
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$19.95
Typical High
$35.48