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Kansas rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $22.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.47 / $11.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.49 / $16.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $17.38 / $112.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $11.75 / $120.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $10.72 / $24.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $11.22 / $17.38