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Alaska rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $3.98 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $5.75 / $5.89
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.89 / $19.95
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.89 / $5.89
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.89 / $7.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $6.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $4.47 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $12.30