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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
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $3.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $8.91 / $12.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $5.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.34 / $3.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.82 / $3.63