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North Carolina rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.01 / $21.01 / $25.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.19 / $21.01 / $21.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.23 / $23.09 / $43.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.32 / $17.98 / $19.19
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 / $27.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $21.01 / $27.49
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $15.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $28.80 / $44.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $11.39 / $16.98
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $113.95 / $113.95
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.47 / $119.47 / $179.93