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Nebraska 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 / $3.98 / $26.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.75 / $5.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $7.08 / $10.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $8.51 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $6.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $8.32 / $15.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.71 / $15.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.75 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.88 / $4.57