go back

New York rates for HCPCS A4220

Refill kit for implantable infusion pump

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
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $10.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.00 / $22.00 / $22.00
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.00 / $22.00 / $22.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $5.95
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.00 / $22.00 / $22.00
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.00 / $22.00 / $22.00