go back

Michigan rates for HCPCS A4380

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.72 / $39.72 / $39.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.78 / $39.72 / $39.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.95 / $157.29 / $286.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.55 / $52.16 / $70.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.90 / $33.90 / $33.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.73 / $41.73 / $41.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.45 / $34.45 / $35.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.80 / $34.45 / $43.37
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.69 / $37.69 / $39.72
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.78 / $39.72 / $58.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.16 / $32.70 / $44.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $24.49 / $37.33