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Indiana rates for HCPCS A4354

Insertion Tray With Drainage Bag But Without Catheter (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.93 / $13.93 / $16.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.10 / $9.90 / $13.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.43 / $7.43 / $14.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.43 / $7.43 / $10.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.26 / $21.14 / $24.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.07 / $19.51 / $24.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.42 / $8.42 / $16.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.66 / $8.11 / $11.64