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Refill Kit for Implantable Infusion Pump

Iowa rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated July 2026.

Facilitymedian $20 · 10th–90th $20$680%50%90th$20Professionalmedian $20 · 10th–90th $20$490%50%90th$20$0.5$2.0$10.0$50.0$200.0

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
$19.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$41.69
Typical High
$48.98
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$64.57
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$30.90
Typical High
$69.18
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.72
Median
$60.26
Typical High
$60.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.74
Median
$60.26
Typical High
$60.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.74
Median
$52.48
Typical High
$52.48
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$38.90
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.60
Typical High
$0.60