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Illinois rates for HCPCS A4388

Ostomy pouch, drainable, with extended wear barrier attached, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.42 / $3.42 / $3.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.42 / $6.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.53 / $16.48 / $53.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.66 / $4.57 / $4.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $3.66 / $6.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.66 / $7.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.94 / $8.26 / $14.76
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $7.92 / $7.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.77 / $7.61 / $9.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $2.35 / $6.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $3.04 / $5.34