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Washington 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
$5.39 / $12.24 / $12.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $5.39 / $13.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.18 / $6.66 / $6.66
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.33 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.93 / $8.49 / $50.70
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.48 / $10.90 / $19.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.48 / $11.50 / $19.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.57 / $7.30 / $8.02
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.21 / $9.94 / $10.28
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.98 / $10.18 / $10.28
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.90 / $8.33 / $15.40
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.90 / $9.01 / $13.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.56 / $8.08 / $10.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.15 / $4.70 / $8.32
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.02 / $6.02