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Pennsylvania rates for HCPCS A4363

Ostomy clamp, any type, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $2.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $2.02 / $2.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.31 / $3.31
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $3.31 / $3.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $1.99 / $3.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $2.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $2.59 / $4.34
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $2.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $2.02 / $3.31
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $4.50 / $6.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $1.99 / $3.55
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $3.75
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.36 / $3.15 / $3.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $3.15 / $3.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.65 / $2.98