go back

Nebraska 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
$4.13 / $4.13 / $4.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.13 / $4.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $4.46 / $4.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $4.83 / $4.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $5.50 / $5.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.36 / $5.63 / $8.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.79 / $5.16 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $2.50 / $4.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.49 / $5.50 / $6.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $6.50 / $10.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $2.50 / $3.27