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Oklahoma 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
$1.88 / $15.85 / $22.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.62 / $15.84 / $15.85
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.41 / $28.41 / $35.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.41 / $25.41 / $25.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $15.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.62 / $19.61 / $42.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $18.11 / $125.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.77 / $13.15 / $19.23