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South 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
$4.79 / $4.79 / $4.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $4.79 / $5.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.05 / $7.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.36 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $4.44
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.53 / $5.15 / $9.41
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $4.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.05 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.70 / $3.84