go back

Virginia 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 / $5.37
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $55.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $21.20 / $36.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.95 / $5.95 / $5.95
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.21 / $49.98 / $9,929.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.21 / $49.98 / $9,929.00