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Montana 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
$9.44 / $35.95 / $35.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $10.39 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.85 / $8.81 / $11.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $11.19 / $11.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.85 / $8.82 / $11.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $5.29 / $6.22