go back

Arizona rates for HCPCS A4221

Supplies for maintenance of noninsulin drug infusion catheter, per week (list drugs separately)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $16.98 / $28.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $28.18 / $28.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $11.75 / $28.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $31.62 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $25.12 / $51.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $13.18 / $125.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $13.18 / $20.42