go back

Vermont rates for HCPCS A4220

Refill Kit For Implantable Infusion Pump (Special Coverage Instructions Apply. See Cim: 60-14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60