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Arkansas rates for HCPCS A4412

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), without filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $3.04 / $3.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.80 / $4.80 / $4.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.78 / $3.78 / $3.78
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $3.78 / $3.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.27 / $2.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.70 / $2.27