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Montana rates for HCPCS A4380

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $37.15 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $48.98 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $37.15 / $54.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $51.29 / $100.00
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $51.29 / $100.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $48.98 / $63.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $54.95 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $19.95 / $20.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $21.88 / $26.30