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Washington rates for HCPCS A4220

Refill kit for implantable infusion pump

Facilitymedian $195 · 10th–90th $20–$1950%50%10th$195Professionalmedian $20 · 10th–90th $20–$200%50%$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.91 / $0.91 / $0.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $24.55 / $34.67
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $28.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $69.18