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Nebraska 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
Facility
Modifier
Low / Median / High Price
$6.38 / $6.38 / $6.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $6.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $4.62 / $4.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $7.44 / $7.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $8.47 / $8.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $8.47 / $13.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.16 / $7.70 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $3.84 / $6.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.44 / $8.47 / $10.68
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $9.97 / $16.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $3.84 / $5.01