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North Dakota 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
$2.75 / $2.75 / $2.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.41 / $2.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $4.18 / $4.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.55 / $5.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.07 / $2.75 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.76 / $3.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.88 / $3.06