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Louisiana rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.44 / $4.23 / $4.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $4.23 / $4.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.21 / $8.91 / $12.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $4.25 / $4.25
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $4.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $4.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $2.77 / $3.92