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Mississippi 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
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.00 / $33.00 / $33.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $32.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00