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Missouri 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
$2.23 / $3.63 / $5.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.23 / $2.93 / $5.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $2.60 / $4.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $3.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.42 / $4.69 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.60 / $4.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.60 / $3.72