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Montana rates for HCPCS A4389

Ostomy pouch, drainable, with barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.45 / $25.05 / $25.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.47 / $8.47 / $8.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $9.10 / $9.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.38 / $9.10 / $9.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.23 / $8.67 / $9.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.84 / $9.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.33 / $3.68 / $4.21