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South Carolina rates for HCPCS A4423

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $2.06 / $2.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.27 / $3.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.56 / $1.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.56 / $1.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $2.20 / $4.08
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $1.75 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.17 / $1.56