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Texas rates for HCPCS A4361

Ostomy Faceplate Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.81 / $16.63 / $18.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.50 / $16.85 / $22.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.50 / $20.67 / $74.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.21 / $12.21 / $13.71
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.65 / $25.65 / $25.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.42 / $15.42 / $17.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $13.11 / $18.14
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $116.25 / $121.84
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.74 / $169.70 / $169.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.02 / $19.27 / $25.65
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.70 / $23.09 / $25.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.02 / $18.37 / $25.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $13.11 / $20.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $11.74 / $15.61
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.93 / $10.93 / $25.65