go back

Arkansas 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
Facility
Modifier
Low / Median / High Price
$4.03 / $4.03 / $4.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $4.03 / $4.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.18 / $3.18 / $3.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.34 / $6.34 / $6.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.00 / $5.00 / $6.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $6.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $3.76
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.66 / $3.66 / $3.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $2.25 / $3.01