go back

Alaska rates for HCPCS A4222

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.26 / $52.26 / $52.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.47 / $52.26 / $73.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.39 / $52.30 / $143.34
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.62 / $53.62 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.40 / $53.62 / $53.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.45 / $52.26 / $73.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.61 / $45.45 / $55.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.27 / $28.53 / $136.35