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South Dakota rates for HCPCS A4220

Refill kit for implantable infusion pump

Facilitymedian $20 · 10th–90th $20–$600%50%90th$20Professionalmedian $20 · 10th–90th $20–$490%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $48.98
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $33.88 / $64.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $60.26 / $60.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $37.15 / $42.66
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60