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Montana rates for HCPCS A4423

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $7.50 / $7.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.52 / $2.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $2.72 / $2.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $2.72 / $2.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $2.59 / $2.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $2.04 / $2.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.10 / $1.30