go back

Oregon 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
$18.20 / $32.75 / $53.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.83 / $110.41 / $132.46
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.26 / $47.78 / $80.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.02 / $46.39 / $50.17
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.00 / $52.56 / $60.21
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.02 / $53.92 / $53.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.26 / $48.59 / $80.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $45.38 / $53.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.56 / $52.56 / $60.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $25.69 / $48.59