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Tennessee 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
$2.69 / $2.69 / $3.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $3.30 / $4.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.10 / $4.69 / $4.69
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 / $3.68
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.58 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.95 / $25.95 / $39.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.42 / $3.16