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Refill Kit for Implantable Infusion Pump

Michigan rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated July 2026.

Facilitymedian $20 · 10th–90th $14$300%50%10th90th$20Professionalmedian $20 · 10th–90th $20$320%50%90th$20$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$74.13
Typical High
$74.13
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$19.95
Typical High
$34.67
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$19.95
Typical High
$22.39
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13