go back

Minnesota 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 / $2.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $2.45 / $2.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $4.09 / $5.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.08 / $3.73 / $3.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $11.38 / $31.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.76 / $5.72
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $10.92 / $24.89
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.50 / $4.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $3.85 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.81 / $3.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.83 / $5.08