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Tennessee 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
$1.34 / $1.34 / $1.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.64 / $2.27
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.68 / $1.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $2.33 / $2.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.56 / $1.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.84
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.26 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.90 / $12.90 / $19.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.21 / $1.58