Refill kit for drug infusion pump

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Kt Infs Cath Acc Port Snchr

Payers reporting HCPCS A4220

Payer pricing summary

Low

Average

$223

Median

$75

High

$3.7k

Payer rate distribution

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#
1	Bcbs Id percent of total billed charges · bothfrom % of charges	5	$287	$289	$168	58%	3–30	$97 – $519
2	Aetna fee schedule · outpatient · +12 other terms	32	$24	$34	$26	78%	—	$12 – $128
3	Blue Cross Blue Shield facility · fee schedule · outpatient · +14 other terms	25	$143	$157	$160	102%	—	$0 – $475
4	WellCare percent of total billed charges · outpatientfrom % of charges · +1 other terms	18	$3	$4	$4	98%	—	$2 – $19
5	Medcost percent of total billed charges · inpatientfrom % of charges · +4 other terms	17	$10	$12	$9	73%	—	$4 – $57
6	Phcs percent of total billed charges · bothfrom % of charges · +4 other terms	17	$180	$180	$31	17%	—	$123 – $228
7	Beechstreet percent of total billed charges · inpatientfrom % of charges · +3 other terms	16	$16	$16	$0	3%	—	$16 – $17
8	Anthem facility · case rate · outpatient · +7 other terms	15	$10	$11	$3	23%	—	$7 – $17
9	Caresource facility · case rate · outpatient · +6 other terms	15	$10	$11	$3	23%	—	$7 – $17
10	Molina facility · case rate · outpatient · +7 other terms	15	$10	$11	$3	23%	—	$7 – $17
11	UnitedHealthcare facility · case rate · outpatient · +13 other terms	15	$10	$11	$3	23%	—	$7 – $17
12	Wellmark fee schedule · both · +1 other terms	13	$1	$1	$3	280%	—	$1 – $20
13	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$107	$68	$59	87%	—	$0 – $133
14	Oscar percent of total billed charges · outpatientfrom % of charges · +1 other terms	12	$18	$67	$69	104%	—	$4 – $148
15	Optum facility · case rate · outpatient · +4 other terms	11	$10	$10	$2	22%	—	$9 – $15
16	Cigna professional · fee schedule · outpatient · +10 other terms	10	$4	$7	$7	108%	—	$3 – $23
17	Clover facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	10	$14	$14	—	—	—	$14 – $14
18	Magellan percent of total billed charges · outpatientfrom % of charges · +1 other terms	10	$11	$11	—	—	—	$11 – $11
19	Medica fee schedule · both · +6 other terms	9	$34	$34	—	—	—	$34 – $34
20	Ucare fee schedule · both · +3 other terms	9	$34	$34	$2	5%	—	$32 – $37
21	Aetna Better Health fee schedule · inpatient · +5 other terms	7	$21	$21	—	—	—	$21 – $21
22	Bcbs Tx facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	6	$426	$356	$344	97%	—	$27 – $753
23	Humana fee schedule · outpatient · +11 other terms	6	$20	$28	$19	69%	—	$20 – $75
24	Tricare fee schedule · outpatient · +2 other terms	5	$315	$315	—	—	—	$315 – $315
25	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$56	$59	$3	6%	—	$56 – $63

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