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Virginia 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
$28.84 / $28.84 / $34.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.41 / $30.15 / $34.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.10 / $26.10 / $39.76
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.04 / $35.04 / $35.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.75 / $33.75 / $55.82
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
$40.61 / $55.90 / $79.31
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $44.21 / $70.16
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $79.00 / $111.34
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.86 / $49.15 / $81.23
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.86 / $49.15 / $81.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.42 / $27.39 / $47.19