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Michigan rates for HCPCS A4380

Ostomy pouch, urinary, with faceplate attached, rubber, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $33.11 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $158.49 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $52.48 / $54.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $34.67 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $29.51 / $60.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $100.00 / $109.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $41.69 / $64.57
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $34.67 / $35.48
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $29.51 / $37.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $19.95 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $24.55 / $37.15