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Illinois rates for HCPCS A4355

Irrigation tubing set for continuous bladder irrigation through a three-way indwelling Foley catheter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.00 / $7.00 / $7.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.81 / $7.00 / $12.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.31 / $31.47 / $109.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $13.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $12.77
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.12 / $14.85 / $19.20
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $16.20 / $16.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.82 / $16.95 / $18.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $6.22 / $11.01