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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
$3.71 / $3.71 / $4.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.30 / $3.71 / $4.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.05 / $4.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $4.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $4.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.49 / $5.99 / $7.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $4.00 / $6.91
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $7.87 / $9.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $4.73 / $8.19
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.73 / $8.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.99 / $4.29