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Washington rates for HCPCS A4377

Ostomy Pouch Drainable For Use On Faceplate Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $7.70 / $8.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $3.39 / $8.11
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.19 / $5.29 / $29.83
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 / $4.44
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $5.99 / $10.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.48 / $6.15 / $10.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.59 / $5.05
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.38 / $5.85 / $5.99
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.99 / $6.59
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $5.24 / $9.69
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.67 / $8.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $5.09 / $6.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $2.54 / $4.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.51 / $3.51