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Iowa rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.32 / $3.32 / $3.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $3.31 / $4.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $5.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.73 / $7.50
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.94 / $5.73 / $8.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.55 / $6.05 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.62 / $7.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.72 / $5.73 / $6.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.48 / $6.66 / $10.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.60 / $6.09
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.69 / $4.69 / $4.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.71 / $4.69 / $4.69