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Michigan rates for HCPCS A4398

Ostomy Irrigation Supply; Bag Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.70 / $14.70 / $280.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.52 / $14.70 / $14.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.23 / $58.75 / $106.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.34 / $19.30 / $26.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.42 / $11.42 / $12.55
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $15.45 / $15.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.60 / $11.60 / $14.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.37 / $12.20 / $16.05
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.95 / $29.53 / $280.80
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $14.70 / $23.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.76 / $12.20 / $16.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.41 / $9.07 / $13.81