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Illinois 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
$28.18 / $28.18 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $33.11 / $51.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $47.86 / $70.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $125.89 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $39.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $66.07 / $117.49
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $45.71 / $48.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $25.70 / $42.66