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Indiana 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
$44.51 / $44.51 / $47.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.74 / $30.15 / $44.51
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $48.06 / $48.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.28 / $24.28 / $46.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.28 / $24.28 / $34.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.78 / $62.11 / $71.67
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.78 / $57.34 / $67.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $53.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.85 / $27.57 / $46.73