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Oregon 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
$1.00 / $3.02 / $5.01
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 / $3.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $10.96 / $12.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.27 / $4.68 / $6.61
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.90 / $6.61
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.37 / $5.89 / $6.03
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.03 / $6.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $5.25 / $7.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $5.75 / $70.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.76 / $6.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $1.95 / $2.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.51 / $4.79