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Alaska rates for HCPCS A4425

Ostomy pouch, drainable; for use on barrier with nonlocking flange, with filter (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.56
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $4.75 / $7.50
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $4.38 / $4.88
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.96 / $4.88 / $10.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $4.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $4.16 / $10.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $4.78