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Michigan rates for HCPCS A4400

Ostomy Irrigation Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.19 / $44.19 / $44.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.67 / $44.19 / $44.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.85 / $175.03 / $318.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.14 / $58.04 / $78.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.47 / $42.47 / $44.38
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.24 / $48.24 / $48.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.02 / $41.02 / $41.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.86 / $38.00 / $79.92
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.94 / $44.19 / $52.46
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.64 / $44.19 / $60.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.34 / $36.68 / $49.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.67 / $27.74 / $41.54