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Oklahoma 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
$1.87 / $1.87 / $1.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.87 / $1.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $2.75 / $2.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.89 / $3.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.87 / $2.50 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.79 / $3.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.48 / $3.97