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North Carolina rates for HCPCS A4220

Refill kit for implantable infusion pump

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $222.53 / $222.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.33 / $74.69 / $79.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.80 / $21.20 / $40.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $16.80 / $16.80
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.10 / $13.10 / $44.51
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $100.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.17 / $51.17 / $51.17