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Montana 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
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $10.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $8.51 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $8.51 / $8.51
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $7.94 / $15.49
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $7.94 / $15.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $7.41 / $9.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $8.51 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $3.09 / $3.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $3.39 / $3.98