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Michigan 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
$9.49 / $9.49 / $9.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $9.49 / $9.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.86 / $37.57 / $68.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.84 / $12.46 / $16.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.98 / $7.98 / $8.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.97 / $9.97 / $9.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.08 / $5.85 / $10.36
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.00 / $9.00 / $9.49
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.48 / $9.49 / $14.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.71 / $5.89 / $8.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $5.74 / $8.91