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Alaska rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.33 / $7.33 / $7.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $4.62 / $4.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.93 / $4.62 / $4.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.32 / $7.32 / $11.55
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.74 / $6.74 / $7.52
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.09 / $7.52 / $15.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $6.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $6.20 / $9.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $3.84 / $7.36