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Tennessee 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
$4.51 / $4.51 / $5.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.16 / $5.61 / $7.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.68 / $5.68 / $5.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.21 / $7.87 / $7.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.18 / $6.18 / $6.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $7.06
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.87 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.70 / $50.70 / $71.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.91 / $4.16 / $6.22