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West Virginia rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.24 / $13.24 / $13.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.24 / $14.71 / $16.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.59 / $32.39 / $41.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.59 / $16.79 / $28.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $28.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $116.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.76 / $12.03 / $22.33