go back

Michigan rates for HCPCS A4311

Insertion Tray Without Drainage Bag With Indwelling Catheter Foley Type Two-Way Latex With Coating (Teflon Silicone Silicone Elastomer Or Hydrophilic Etc.) (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.76 / $15.76 / $15.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.53 / $15.76 / $15.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.33 / $62.42 / $113.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.67 / $20.70 / $27.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.46 / $13.46 / $13.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.55 / $16.55 / $16.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.94 / $12.44 / $12.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.94 / $12.81 / $17.21
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.97 / $14.97 / $15.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.45 / $15.76 / $21.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.48 / $13.11 / $17.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.87 / $9.56 / $14.63