go back

South Carolina rates for HCPCS A4387

Ostomy Pouch Closed With Barrier Attached With Built-In Convexity (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $2.50 / $2.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $4.00 / $5.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $2.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.89 / $2.33
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $2.75 / $5.08
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $4.00 / $4.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.12 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.55 / $2.98