go back

Tennessee rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.39 / $12.39 / $15.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.44 / $15.19 / $20.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.30 / $21.59 / $21.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $15.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.70 / $112.69 / $113.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.47 / $119.47 / $179.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.58 / $11.17 / $14.60