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Alaska rates for HCPCS A4355

Irrigation Tubing Set For Continuous Bladder Irrigation Through A Three-Way Indwelling Foley Catheter Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.98 / $11.98 / $11.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $6.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $3.41 / $3.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.84 / $11.95 / $18.87
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.91 / $10.91 / $12.29
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.97 / $12.29 / $25.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $3.41 / $7.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.08 / $10.01 / $15.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.28 / $12.04 / $21.99