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Illinois rates for HCPCS A4399

Ostomy Irrigation Supply; Cone/Catheter With Or Without Brush Cm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.63 / $9.63 / $9.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $9.63 / $15.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.03 / $46.65 / $150.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.53 / $12.86 / $12.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.29 / $10.29 / $16.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.75 / $10.29 / $19.88
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.05 / $30.36 / $40.96
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.28 / $22.28 / $22.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.16 / $23.31 / $25.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.06 / $8.47 / $15.14