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Wisconsin rates for HCPCS A4220

Refill kit for implantable infusion pump

Facilitymedian $30 · 10th–90th $20$1230%20%40%10th90th$30Professionalmedian $20 · 10th–90th $20$240%50%90th$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. 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
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $6.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.91 / $43.65 / $50.12
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $36.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $120.23 / $162.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $60.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $5,888.44 / $5,888.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $7.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $32.36 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $48.98