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Hawaii rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $5.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $5.75 / $8.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $6.61 / $6.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $6.61 / $7.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $2.29 / $2.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $4.68 / $7.08