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Idaho rates for HCPCS A4417

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $7.07 / $7.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $3.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $3.66 / $7.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.69 / $4.95 / $5.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $5.21 / $10.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $3.65 / $5.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.09 / $3.72