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West 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
$28.24 / $28.24 / $28.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.00 / $29.72 / $34.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.78 / $64.50 / $78.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.78 / $110.78 / $110.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.82 / $55.82 / $55.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $233.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.42 / $33.03 / $60.67