go back

Michigan rates for HCPCS A4419

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.83 / $1.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.41 / $2.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.65 / $7.27 / $13.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.41 / $3.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $1.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.71 / $2.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.48 / $1.64 / $1.83
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.83 / $2.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.23 / $1.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.12 / $1.74