go back

South Carolina rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.19 / $19.19 / $19.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.39 / $19.19 / $21.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $21.44 / $28.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.52 / $15.93 / $15.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.25 / $20.62 / $37.69
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $16.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.21 / $16.21 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $10.81 / $14.43