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Indiana rates for HCPCS A4376

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.94 / $56.94 / $66.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $42.20 / $56.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.31 / $33.31 / $64.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.31 / $33.31 / $45.96
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.86 / $73.13 / $99.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.51 / $73.13 / $89.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.94 / $39.94 / $39.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.95 / $39.94 / $68.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.80 / $31.57 / $46.99