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Texas 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
$2.73 / $6.16 / $7.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $6.25 / $8.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.71 / $6.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.09 / $10.52 / $26.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.53 / $4.53 / $5.08
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.88 / $7.61 / $11.76
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.51 / $9.51 / $9.51
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 / $5.25 / $6.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.70 / $50.70 / $71.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.81 / $7.15 / $9.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.82 / $8.56 / $9.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.81 / $6.82 / $9.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $8.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $4.74 / $6.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $9.51