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Louisiana rates for HCPCS A4367

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.31 / $6.55 / $6.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.31 / $6.55 / $7.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.06 / $13.77 / $19.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $6.58 / $6.58
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.67 / $6.18 / $6.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.52 / $7.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.91 / $4.40 / $6.72