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Michigan rates for HCPCS A4376

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.62 / $50.62 / $50.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $50.62 / $50.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.62 / $200.48 / $365.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.16 / $66.48 / $89.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.21 / $43.21 / $43.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.18 / $53.18 / $53.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.94 / $39.94 / $39.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.44 / $41.69 / $55.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.04 / $48.04 / $50.62
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.93 / $50.62 / $74.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.35 / $41.69 / $56.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.11 / $30.67 / $45.87