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Refill Kit for Implantable Infusion Pump

Montana rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated July 2026.

Facilitymedian $75,858 · 10th–90th $64,565$91,2010%50%10th90th$75,858Professionalmedian $20 · 10th–90th $20$200%50%$20$1.0$10.0$100.0$1.0K$10.0K$100.0K

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$56.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$0.91
Typical High
$56.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$79.43
Typical High
$85.11