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Montana rates for HCPCS A5112

Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.62 / $15.62 / $139.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.25 / $47.25 / $47.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.06 / $50.80 / $50.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.93 / $50.80 / $50.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.54 / $48.38 / $50.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.34 / $38.11 / $50.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.54 / $20.51 / $27.70