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Nebraska rates for HCPCS A4315

Insertion Tray With Drainage Bag With Indwelling Catheter Foley Type Two-Way All Silicone (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.52 / $30.52 / $30.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.52 / $30.52 / $30.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.39 / $35.63 / $35.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.29 / $40.54 / $40.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $40.54 / $62.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.82 / $36.85 / $165.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.26 / $18.38 / $30.64
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.43 / $40.54 / $51.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.22 / $47.36 / $80.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.26 / $18.38 / $24.09