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Wyoming 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
Professional
Modifier
Low / Median / High Price
$1.63 / $1.63 / $3.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $3.69 / $3.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.69 / $3.69 / $3.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $4.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $2.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.60 / $2.16