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Missouri rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $7.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.16 / $5.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.63 / $6.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $5.25 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $29.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $2.34 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.88 / $4.27