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Texas rates for HCPCS A4433

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $3.02 / $3.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $2.45 / $2.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $3.80 / $4.79
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $4.79 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $2.82 / $2.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.82
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $35.48 / $35.48
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.51 / $3.98 / $6.61
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $4.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $81.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $3.80 / $6.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $3.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.82 / $2.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.14 / $2.82
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79