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Montana rates for HCPCS A4416

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.30 / $11.10 / $11.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.76 / $3.76 / $3.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $4.04 / $4.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.38 / $4.04 / $4.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.87 / $3.85 / $4.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.72 / $3.03 / $4.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.63 / $1.92