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Nebraska 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
$21.99 / $21.99 / $21.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.11 / $21.99 / $21.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.23 / $24.46 / $24.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.25 / $38.57 / $70.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.99 / $37.38 / $56.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.11 / $13.15 / $27.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.79 / $36.07 / $58.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.16 / $37.02 / $60.87
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.60 / $39.20 / $52.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.11 / $13.15 / $21.92