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Minnesota 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 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.62 / $7.08 / $10.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.03 / $6.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $22.91 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $8.13 / $9.12
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $22.91 / $42.66
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $6.03 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.51 / $6.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $2.29 / $2.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.82 / $6.92