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California rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.03 / $1.12 / $11.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.73 / $11.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.39 / $1.67 / $4.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $3.58
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.05 / $5.27 / $8.14
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.08 / $8.27 / $14.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $3.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $2.67
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.08 / $3.85 / $4.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $2.70 / $5.97
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.17 / $19.17 / $28.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.89 / $7.89 / $7.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $3.40 / $3.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.31 / $3.66
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.26 / $7.26 / $7.26
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.08 / $4.50 / $5.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.63 / $3.66