go back

Montana rates for HCPCS A4314

Insertion Tray With 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
Professional
Modifier
Low / Median / High Price
$25.76 / $64.80 / $101.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.43 / $31.43 / $64,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.43 / $31.43 / $31.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.22 / $33.79 / $33.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $33.79 / $33.79
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.20 / $32.18 / $33.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.17 / $25.92 / $33.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.54 / $14.98 / $17.62