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Illinois rates for HCPCS A4377

Ostomy Pouch Drainable For Use On Faceplate Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.36 / $3.36 / $3.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $3.36 / $5.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.53 / $16.46 / $52.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $4.49 / $4.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $6.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $7.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.99 / $9.66 / $12.80
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.79 / $7.79 / $7.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.71 / $7.49 / $8.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.99 / $5.30