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Missouri rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.28 / $16.73 / $23.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.28 / $13.48 / $26.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.03 / $12.03 / $19.73
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 / $13.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.16 / $21.59 / $112.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $11.97 / $19.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $11.97 / $17.18