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North Carolina rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $5.24 / $6.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.79 / $5.24 / $5.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $8.88 / $10.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.08 / $4.49 / $4.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $7.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $5.24 / $6.86
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.20 / $7.20 / $11.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.85 / $4.33
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.83 / $29.83 / $44.93