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Iowa rates for HCPCS A4623

Tracheostomy Inner Cannula. (Rvsd 1/1/04) Ecial Coverage Instructions Apply. See Cim: 65-16)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.84 / $5.84 / $6.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $5.53 / $6.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $8.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.21 / $8.57 / $13.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.18 / $7.90 / $14.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.31 / $10.00 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $4.61 / $11.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.57 / $8.68 / $11.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.75 / $10.13 / $16.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.88 / $10.63
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.40 / $7.40 / $7.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.85 / $7.40 / $7.40