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Arizona rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $3.59 / $5.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.50 / $16.23 / $29.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $4.79 / $6.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $4.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $4.29 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.54 / $3.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.54 / $3.83