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Michigan rates for HCPCS A4435

Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.13 / $6.13 / $6.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $6.13 / $6.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.05 / $8.05 / $8.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.65 / $8.05 / $10.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.23 / $5.23 / $5.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.44 / $6.44 / $6.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $4.84 / $4.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $5.00 / $6.70
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.88 / $5.88 / $6.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.11 / $6.13 / $8.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $4.61 / $6.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $3.76 / $5.70