go back

Rhode Island rates for HCPCS A4221

Supplies For Maintenance Of Non-Insulin Drug Infusion Catheter Per Week (List Drug Separately)(Desc Revised 1/1/2017)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.06 / $13.06 / $13.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.06 / $13.82 / $18.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.69 / $50.16 / $57.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.23 / $22.64 / $22.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $15.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.81 / $14.26 / $22.03