A4217 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.
Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?
Cost Key: |
Lower Cost | Medium Cost | Higher Cost |
Facility ![]() |
City/State |
Average Cost Range ![]() |
||
|---|---|---|---|---|
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Allina Community Pharmacies (15) | $13.78 - $16.84 | |||||
| Abbott NW Medical Bldg Pharmacy | Minneapolis, MN | $13.78 - $16.84 | |||||
| Abbott NW Piper Bldg Pharmacy | Minneapolis, MN | $13.78 - $16.84 | |||||
| Cottage Grove Pharmacy | Cottage Grove, MN | $13.78 - $16.84 | |||||
| Healthcare Pharmacy | Coon Rapids, MN | $13.78 - $16.84 | |||||
| Heart Hospital | Minneapolis, MN | $13.78 - $16.84 | |||||
| Medical Arts Building | Minneapolis, MN | $13.78 - $16.84 | |||||
| Mercy Hospital Outpatient Pharmacy | Coon Rapids, MN | $13.78 - $16.84 | |||||
| Owatonna Pharmacy Care | Owatonna, MN | $13.78 - $16.84 | |||||
| PEI Pharmacy | Minneapolis, MN | $13.78 - $16.84 | |||||
| Ritchie Medical Plaza Pharmacy | Saint Paul, MN | $13.78 - $16.84 | |||||
| Rum River Drug | Cambridge, MN | $13.78 - $16.84 | |||||
| United Hospital Outpatient Pharmacy | Saint Paul, MN | $13.78 - $16.84 | |||||
| Unity Community Pharmacy | Fridley, MN | $13.78 - $16.84 | |||||
| Westhealth Pharmacy | Plymouth, MN | $13.78 - $16.84 | |||||
| Woodbury Pharmacy | Woodbury, MN | $13.78 - $16.84 | |||||
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Allina Home Oxygen & Medical Equipment (10) | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Saint Paul, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | New Ulm, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Buffalo, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Fridley, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Saint Paul, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Coon Rapids, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Hutchinson, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Minneapolis, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Cambridge, MN | $13.78 - $16.84 | |||||
| Allina Home Oxygen & Medical Equipment | Owatonna, MN | $13.78 - $16.84 | |||||
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Apria Healthcare Inc - Home Oxygen & Medical Equipment (22) | $2.83 - $5.89 | |||||
| Apria Healthcare Inc | Rochester, MN | $2.83 - $5.89 | |||||
| Apria Healthcare Inc | Spearfish, SD | $2.83 - $5.89 | |||||
| Apria Healthcare Inc | Wisconsin Rapids, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc | Rothschild, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Saint Cloud, MN | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rapid City, SD | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | New Berlin, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Saint Paul, MN | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Sioux Falls, SD | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Marshfield, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Green Bay, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Duluth, MN | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Onalaska, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Neenah, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Minocqua, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Eau Claire, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rice Lake, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rochester, MN | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Monona, WI | $2.83 - $5.89 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Minnetonka, MN | $2.83 - $5.89 | |||||
| Apria Pharmacy Network | Folcroft, PA | $2.83 - $5.89 | |||||
| Apria Pharmacy Network | Oxnard, CA | $2.83 - $5.89 | |||||
| Aspen Medical Group - Musculoskeletal Center | Saint Paul, MN | $13.78 - $16.84 | |||||
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Corner Medical LLC (5) | $2.83 - $5.89 | |||||
| Corner Medical, LLC | Osseo, MN | $2.83 - $5.89 | |||||
| Corner Medical, LLC | Apple Valley, MN | $2.83 - $5.89 | |||||
| Corner Medical, LLC | Rochester, MN | $2.83 - $5.89 | |||||
| Corner Medical, LLC | Bloomington, MN | $2.83 - $5.89 | |||||
| Corner Medical, LLC | Red Wing, MN | $2.83 - $5.89 | |||||
| Essentia Health Medical Equipment & Supplies | Duluth, MN | $2.83 - $5.89 | |||||
| Handi Medical Supply | Saint Paul, MN | $2.83 - $5.89 | |||||
| Handi Medical Supply | Saint Paul, MN | $2.83 - $5.89 | |||||
| Key Medical Supply Inc | Shoreview, MN | $2.83 - $5.89 | |||||
| Midwest Medical Services | Mounds View, MN | $2.83 - $5.89 | |||||
| Pediatric Home Services - Home Medical Equipment | Roseville, MN | $2.83 - $5.89 | |||||
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Reliable Medical Supply Inc (3) | $2.83 - $5.89 | |||||
| Reliable Medical Supply, Inc | Brooklyn Park, MN | $2.83 - $5.89 | |||||
| Reliable Medical Supply, Inc | Waite Park, MN | $2.83 - $5.89 | |||||
| Reliable Medical Supply, Inc | Buffalo, MN | $2.83 - $5.89 | |||||
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Sports and Orthopaedic Specialists (4) | $13.78 - $16.84 | |||||
| Sports and Orthopaedic Specialists P.A. | Blaine, MN | $13.78 - $16.84 | |||||
| Sports and Orthopaedic Specialists P.A. | Edina, MN | $13.78 - $16.84 | |||||
| Sports and Orthopaedic Specialists P.A. | Minneapolis, MN | $13.78 - $16.84 | |||||
| Sports and Orthopaedic Specialists P.A. | Saint Cloud, MN | $13.78 - $16.84 |
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