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Ohio rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.23 / $15.23 / $25.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.73 / $15.23 / $20.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.03 / $12.03 / $31.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $23.99 / $32.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.59 / $23.99 / $51.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $16.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.54
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.87 / $15.93 / $15.93
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $15.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.44 / $17.11 / $22.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.80 / $11.16 / $15.33