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Montana rates for HCPCS A4428

Ostomy Pouch Urinary With Extended Wear Barrier Attached With Faucet-Type Tap With Valve (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.82 / $26.27 / $26.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.90 / $8.90 / $8.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $9.57 / $9.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.63 / $9.57 / $9.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.42 / $9.11 / $9.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.43 / $7.18 / $9.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $3.86 / $4.54