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Rhode Island 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
$26.96 / $26.96 / $26.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.96 / $28.53 / $34.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.27 / $95.12 / $114.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.72 / $46.73 / $46.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.78 / $30.12 / $45.12