go back

Michigan rates for HCPCS A4426

Ostomy pouch, drainable; for use on barrier with locking flange (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $11.48 / $21.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $2.45 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.29 / $4.57
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $3.98 / $7.94
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $4.68
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.40
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.29 / $2.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $1.48 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.78 / $2.75