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Wisconsin rates for HCPCS A4388

Ostomy Pouch Drainable With Extended Wear Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.54 / $3.54 / $3.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $3.86 / $4.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.09 / $6.70 / $11.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.48 / $5.66 / $7.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $13.03 / $13.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $16.22 / $25.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $9.05 / $11.53
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $5.09 / $7.00
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $6.09 / $7.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.97 / $6.37 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.43 / $3.04 / $6.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $5.31 / $7.00
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $6.09 / $7.31
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.09 / $9.39 / $15.06
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $11.90 / $80.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.66 / $30.33
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.09 / $6.09 / $6.09
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.09 / $6.09 / $6.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.59 / $3.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $3.04 / $6.09