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Oklahoma 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
$2.25 / $2.25 / $2.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $3.31 / $3.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $3.31 / $3.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.21 / $2.27 / $2.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $2.36 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.80 / $4.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.70 / $2.29