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Michigan rates for HCPCS A4404

Ostomy Ring Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $1.78 / $1.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $1.78 / $1.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.54 / $7.06 / $12.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.34 / $3.16
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.40
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.41 / $1.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.97 / $1.08 / $1.78
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.78 / $2.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.12 / $1.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $1.09 / $1.66