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Texas rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.98 / $15.55 / $17.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.98 / $15.76 / $21.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.63 / $13.71 / $15.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.42 / $11.42 / $12.82
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.69 / $113.95 / $113.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.47 / $119.47 / $179.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $17.64 / $23.99
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.68 / $21.59 / $23.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.57 / $17.18 / $23.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $18.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.48 / $11.07 / $14.60
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.03 / $12.03 / $23.99