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South Carolina 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
$7.66 / $7.66 / $7.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $7.66 / $7.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.36 / $4.36 / $6.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $8.83 / $11.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.69 / $6.18 / $6.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.18 / $7.06
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.74 / $8.00 / $15.05
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.46 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $4.54 / $5.87