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Montana rates for HCPCS A4379

Ostomy Pouch Urinary With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $60.55 / $60.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.91 / $19.47 / $22.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.91 / $15.77 / $22.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.22 / $20.98 / $22.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.91 / $16.53 / $22.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.03 / $8.90 / $10.47