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Indiana rates for HCPCS A4387

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $2.69 / $3.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.00 / $2.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.65 / $1.65 / $3.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $1.65 / $4.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.36 / $3.45 / $4.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $3.45 / $4.24
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 / $1.89 / $3.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.57 / $3.37