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Virginia 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 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $6.31
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.07 / $4.17
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $6.17 / $8.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $4.27 / $6.46
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $4.37 / $7.59
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.72 / $3.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $5.37 / $20.89
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $5.37 / $20.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.29 / $2.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $3.02 / $4.57