go back

Minnesota 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
$6.56 / $6.56 / $6.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $6.56 / $7.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $10.97 / $14.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.22 / $9.97 / $10.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.18 / $32.07 / $89.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.72 / $15.24
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.04 / $30.77 / $70.14
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.00 / $12.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.89 / $10.28 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.91 / $4.88 / $11.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.41 / $5.13 / $16.03