go back

Nebraska 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
$6.66 / $6.66 / $6.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.66 / $6.66 / $6.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $7.78 / $7.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $8.86 / $8.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.84 / $8.86 / $13.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.51 / $8.05 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.73 / $4.01 / $6.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.84 / $8.86 / $11.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.02 / $10.34 / $17.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $4.01 / $5.32