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Montana 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
$2.06 / $6.97 / $6.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $2.35 / $2.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $2.52 / $2.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $2.52 / $2.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $2.41 / $2.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $1.95 / $2.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.03 / $1.21