go back

Refill Kit for Implantable Infusion Pump

Wyoming rates for HCPCS A4220

Refill kit for implantable infusion pump

Rates data updated October 2026.

How much rates vary

Facilitymedian $20 · 10th to 90th $20 to $20Professionalmedian $20 · 10th to 90th $1 to $20
$1$2$5$10$20facility $20professional $20

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.98
Median
$3.98
Typical High
$3.98
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.91
Median
$0.91
Typical High
$0.91