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Indiana rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.13 / $5.13 / $5.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $5.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.16 / $6.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $7.41 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.55 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $4.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $2.34 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.88 / $4.27