go back

Georgia rates for HCPCS A4220

Refill Kit For Implantable Infusion Pump (Special Coverage Instructions Apply. See Cim: 60-14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.30 / $189.82 / $189.82