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Arizona rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.88 / $2.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.20 / $11.56 / $20.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $2.50 / $3.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $1.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.61 / $2.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.50 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $2.22 / $3.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.33 / $3.97