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Iowa 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
$2.45 / $2.45 / $2.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.44 / $3.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $4.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $4.24 / $5.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.66 / $3.96 / $5.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $4.47 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.94 / $5.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.22 / $4.24 / $5.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $4.55 / $8.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.92 / $5.01
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $3.47 / $3.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.74 / $3.47 / $3.47