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California 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
$1.34 / $1.47 / $14.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.19 / $13.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.75 / $5.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $2.17 / $5.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $4.65
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.27 / $6.85 / $10.59
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $10.74 / $18.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $5.63
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.00 / $6.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.50 / $7.75
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.90 / $24.90 / $37.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $15.00 / $15.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $4.43 / $5.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $4.76
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.44 / $9.44 / $9.44
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.85 / $7.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.12 / $4.92