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Maine rates for HCPCS A4221

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.82 / $16.18 / $18.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.12 / $13.12 / $14.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $15.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.20 / $20.20 / $20.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.82 / $16.18 / $16.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.33 / $32.20