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Hawaii 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
$19.05 / $28.18 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $53.70 / $72.44
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $61.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $27.54 / $63.10