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Tennessee rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.79 / $5.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.58 / $5.39 / $5.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $4.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.16 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.83 / $29.83 / $44.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.79 / $3.65