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South Carolina 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
Facility
Modifier
Low / Median / High Price
$9.31 / $9.31 / $9.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.60 / $9.31 / $10.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.22 / $10.09 / $14.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $5.85 / $5.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $8.81
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.99 / $10.36 / $18.28
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.67 / $5.67 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.87 / $5.52 / $7.12