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West Virginia rates for HCPCS A4376

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.67 / $36.67 / $36.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $40.75 / $44.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.21 / $89.75 / $116.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.21 / $46.54 / $79.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.94 / $39.94 / $77.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.95 / $39.94 / $321.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.26 / $33.31 / $55.28