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Indiana rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.56 / $20.56 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.24 / $15.23 / $20.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.03 / $12.03 / $23.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.03 / $12.03 / $16.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $26.39 / $35.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.39 / $26.39 / $32.39
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 / $13.54 / $19.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.78 / $11.44 / $16.14