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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
$2.57 / $4.19 / $5.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $3.36 / $6.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $4.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $4.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.79 / $5.39 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.99 / $4.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.96 / $4.29