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Tennessee rates for HCPCS A4420

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $1.72 / $2.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $90.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $1.95