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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
$3.02 / $3.47 / $5.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.47 / $4.79
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 / $3.63
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $44.67 / $44.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $2.34 / $3.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $2.82 / $3.55