go back

Refill Kit for Implantable Infusion Pump

Texas rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated July 2026.

Facilitymedian $20 · 10th–90th $20$1000%50%90th$20Professionalmedian $20 · 10th–90th $17$270%50%10th90th$20$1.0$5.0$20.0$100.0$500.0$2.0K

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,548.13
Typical High
$4,786.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Christus
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$0.91
Typical High
$0.91
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Molina
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$50.12
Providence
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Providence
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$0.91
Typical High
$0.91
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
United
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$19.50
Typical High
$33.88
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$45.71
Typical High
$61.66