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Arizona 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
$1.37 / $3.00 / $4.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $4.76 / $8.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.30 / $4.40 / $5.94
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 / $5.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $3.58 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $2.12 / $3.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $2.12 / $3.20