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Tennessee 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
$13.73 / $13.73 / $24.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.22 / $16.38 / $23.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.15 / $28.41 / $31.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $15.09
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.14 / $120.00 / $120.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.45 / $127.35 / $188.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.81 / $13.22 / $15.45