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Iowa rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $17.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.05 / $15.23 / $20.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $26.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $27.75 / $34.69
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.68 / $20.05 / $23.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.39 / $27.88 / $112.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $12.11 / $32.78
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.31 / $26.39 / $31.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.66 / $29.93 / $50.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.24 / $11.97 / $28.20
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.59 / $21.59 / $21.59
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.05 / $21.59 / $21.59