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Iowa rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $7.08 / $8.91
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $9.55 / $10.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $6.61 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $3.63 / $10.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $6.92 / $7.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $10.00 / $10.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.51 / $4.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.02 / $5.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $5.37 / $5.37