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Alaska rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.03 / $23.03 / $23.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $16.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $9.78 / $13.54
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $6.57 / $6.57
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.79 / $22.99 / $36.29
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.01 / $21.01 / $23.63
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.14 / $23.63 / $48.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $6.57 / $16.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.54 / $20.12 / $48.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.69 / $12.07 / $23.14