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Michigan rates for HCPCS A4389

Ostomy Pouch Drainable 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
$6.61 / $6.61 / $6.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.61 / $6.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.13 / $26.15 / $47.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.24 / $8.67 / $11.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.94 / $6.94 / $6.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $5.22 / $5.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $5.44 / $7.22
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.28 / $6.61 / $7.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.22 / $6.61 / $9.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.35 / $5.44 / $7.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $4.04 / $6.22