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Arizona rates for HCPCS A4222

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.67 / $28.67 / $28.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.17 / $28.67 / $45.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.62 / $29.81 / $73.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.18 / $42.06 / $99.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.79 / $47.78 / $95.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $25.69 / $241.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.44 / $25.60 / $41.71