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Missouri 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
$1.35 / $2.24 / $3.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.76 / $3.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $1.89 / $4.07
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
$1.92 / $3.14 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.70 / $3.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.57 / $3.97