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Missouri 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
$2.66 / $3.75 / $31.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.81 / $5.52
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.50 / $5.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $4.11
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 / $3.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.33 / $4.50 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $2.50 / $4.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.50 / $3.58