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Michigan rates for HCPCS A4424

Ostomy pouch, drainable, with barrier attached, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $5.05 / $5.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.67 / $5.05 / $5.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $3.82 / $3.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.06 / $20.05 / $36.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.32 / $6.65 / $8.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.32 / $4.32 / $4.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $4.12 / $5.53
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.28 / $4.75 / $5.05
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.99 / $5.05 / $6.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.68 / $3.35 / $4.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $3.12 / $4.75