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North Carolina 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
$45.24 / $45.24 / $45.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.72 / $43.06 / $45.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.86 / $62.24 / $94.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $42.17 / $44.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.44 / $49.00 / $85.05
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.00 / $48.60 / $88.33
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,186.91 / $3,349.29 / $13,647.65
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.60 / $57.30 / $102.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.07 / $27.52 / $50.62
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $96.99 / $227.17
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.73 / $247.73 / $358.35