go back

Montana rates for HCPCS A4383

Ostomy pouch, urinary, for use on faceplate, rubber, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.79 / $113.64 / $113.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $36.56 / $41.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $41.35 / $41.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.17 / $39.38 / $41.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.84 / $31.04 / $41.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.10 / $16.70 / $19.12