go back

South 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
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $3.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $5.37 / $6.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $3.16 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $6.03
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $3.31 / $3.72
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $4.68 / $8.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.55 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.04 / $3.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.45 / $3.39