A4353 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.
Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?
Cost Key: |
Lower Cost | Medium Cost | Higher Cost |
Facility ![]() |
City/State | Average Cost Range |
|---|
![]() |
Coborns & Cash Wise Pharmacies (30) | $1.38 - $1.68 | |||
| Coborns Long Term Care Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Hastings, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Delano, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | New Ulm, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Waite Park, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Foley, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Hutchinson, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Albertville, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Princeton, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Willmar, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Glencoe, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Mora, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Little Falls, MN | $1.38 - $1.68 | |||
| Cash Wise Clinic Pharmacy | Willmar, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | New London, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Huron, SD | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Marshall, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Long Prairie, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Saint Cloud, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Elk River, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Moorhead, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Sauk Rapids, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Saint Joseph, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | New Prague, MN | $1.38 - $1.68 | |||
| Coborns Pharmacy | Sauk Centre, MN | $1.38 - $1.68 | |||
| Cash Wise Pharmacy | Owatonna, MN | $1.38 - $1.68 | |||
| Essentia Health Medical Equipment & Supplies | Duluth, MN | $4.95 - $6.05 | |||
| Handi Medical Supply | Saint Paul, MN | $4.95 - $6.05 | |||
| Handi Medical Supply | Saint Paul, MN | $4.95 - $6.05 | |||
![]() |
Mayo Clinic Store (3) | $4.95 - $6.05 | |||
| Mayo Clinic Store-Sleep Apnea Supplies | Rochester, MN | $4.95 - $6.05 | |||
| Mayo Clinic Store - Siebens | Rochester, MN | $4.95 - $6.05 | |||
| Mayo Clinic Store | Rochester, MN | $4.95 - $6.05 | |||
![]() |
Reliable Medical Supply Inc (3) | $4.95 - $6.05 | |||
| Reliable Medical Supply, Inc | Brooklyn Park, MN | $4.95 - $6.05 | |||
| Reliable Medical Supply, Inc | Waite Park, MN | $4.95 - $6.05 | |||
| Reliable Medical Supply, Inc | Buffalo, MN | $4.95 - $6.05 | |||