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Alaska rates for HCPCS A4419

Ostomy pouch, closed; for use on barrier with nonlocking flange, with filter (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.67 / $0.67
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $3.62
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.35
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.35 / $4.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.67 / $2.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $2.00 / $4.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.21 / $2.31