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Oklahoma 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
$1.00 / $3.02 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $3.63 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $6.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $4.27 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.88 / $7.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.34 / $6.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.51 / $3.63