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California rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $26.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $3.02 / $22.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.82 / $7.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.16 / $6.92
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $8.71 / $12.59
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $11.22 / $21.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $3.63 / $4.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.63
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $6.76 / $8.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $5.50 / $10.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $44.67 / $44.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $5.75 / $7.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $5.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $11.22 / $11.22
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $5.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.42 / $2.29 / $2.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.69 / $6.03