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Texas 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
$1.17 / $1.52 / $1.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.54 / $2.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.24 / $1.35 / $1.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.25
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $2.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.40 / $1.41 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.61
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.65 / $11.65 / $17.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $1.72 / $2.34
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.99 / $2.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $1.69 / $2.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $1.09 / $1.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.18 / $1.18 / $2.34