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Ohio 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
$3.31 / $3.31 / $9.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $3.31 / $4.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $2.60 / $6.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.91 / $5.21 / $7.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $5.21 / $11.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $6.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $3.68
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.60
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.13 / $3.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $2.20 / $2.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.44 / $3.32