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Utah rates for HCPCS A4222

Infusion Supplies For External Drug Infusion Pump Per Cassette Or Bag (List

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.87 / $17.87 / $17.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.87 / $28.79 / $146.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $28.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.41 / $34.88 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.45 / $33.45 / $34.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.55 / $25.28 / $41.71