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Georgia 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
$3.17 / $3.17 / $3.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $3.17 / $4.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.59 / $2.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $4.16 / $9.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.89 / $5.00 / $8.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.25 / $5.00 / $7.00
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 / $5.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.00 / $9.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.36 / $4.12