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California rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.43 / $7.05 / $69.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.05 / $10.82 / $69.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.65 / $10.42 / $27.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.03 / $12.03 / $22.31
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.28 / $32.84 / $50.74
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.97 / $51.50 / $90.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.74 / $15.93 / $17.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.54
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.19 / $23.99 / $28.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.39 / $16.79 / $37.18
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $113.95 / $113.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.47 / $119.47 / $179.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.17 / $49.17 / $49.17
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $21.22 / $23.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $21.01
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.28 / $45.28 / $45.28
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.19 / $19.19 / $19.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.14 / $10.18 / $23.99