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Montana rates for HCPCS A4391

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.48 / $28.49 / $28.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.64 / $9.64 / $9.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $10.36 / $10.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.11 / $10.36 / $10.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $9.86 / $10.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.98 / $7.79 / $10.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.79 / $4.19 / $4.93