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North Carolina 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
$4.55 / $4.55 / $5.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.99 / $4.55 / $4.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.18 / $6.93 / $7.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.91 / $4.17
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 / $3.13 / $6.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $4.55 / $5.95
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.47
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.30 / $6.30 / $9.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.47 / $3.72
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.95 / $25.95 / $39.08