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North Dakota 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
$2.27 / $2.27 / $2.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.27 / $2.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.93 / $3.47 / $3.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $3.79 / $4.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.58 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.48 / $2.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.33 / $2.50