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Missouri 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
$1.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.29 / $2.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $2.09 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.20 / $12.02
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $1.78 / $1.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.93 / $1.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.15 / $1.74