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South 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
$40.74 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $33.11 / $44.67
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $56.23 / $57.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $60.26 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $48.98 / $93.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $27.54 / $41.69