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Wisconsin rates for HCPCS A4369

Ostomy skin barrier, liquid (spray, brush, etc.), per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $3.47 / $5.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $3.24 / $3.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $10.47 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $4.68 / $6.61
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $2.82 / $4.90
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $6.46 / $8.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $3.39 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.78 / $4.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $5.25 / $9.55
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $6.92 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $3.47 / $18.20
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.47 / $3.47
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.47 / $3.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.45 / $2.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.70 / $2.75