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Idaho 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
$8.55 / $8.55 / $8.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $6.79 / $6.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $5.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $3.47 / $6.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.75 / $5.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $5.00 / $9.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $5.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.02 / $3.58