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Texas rates for HCPCS A4391

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.93 / $6.40 / $7.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.93 / $6.49 / $8.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.19 / $5.64 / $6.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.70 / $4.70 / $5.28
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.86 / $9.86 / $9.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $6.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.04 / $6.28
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.15 / $49.15 / $74.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.70 / $7.27 / $9.86
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.04 / $8.88 / $9.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.70 / $7.07 / $9.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.04 / $8.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $4.55 / $6.01
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $4.95 / $9.86