go back

Nebraska 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
$4.32 / $4.32 / $4.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.32 / $4.32 / $4.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.58 / $5.04 / $5.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $5.73 / $5.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $5.73 / $8.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.93 / $5.21 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $2.60 / $4.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.72 / $5.73 / $7.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.69 / $6.70 / $11.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.60 / $3.40