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Minnesota 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
$33.13 / $33.13 / $33.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.55 / $33.13 / $42.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $54.95 / $89.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.23 / $53.71 / $56.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.78 / $146.91 / $340.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.06 / $61.91 / $70.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.97 / $134.63 / $321.27
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.50 / $55.50 / $56.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.73 / $47.78 / $79.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.39 / $25.28 / $108.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.14 / $25.28 / $53.51