go back

Montana rates for HCPCS A4400

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.59 / $197.03 / $197.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.68 / $56.68 / $56.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.02 / $60.94 / $60.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.61 / $60.94 / $60.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.22 / $58.04 / $60.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.74 / $46.87 / $64.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.17 / $28.96 / $34.07