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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
$2.93 / $2.93 / $2.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $5.15 / $5.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.23 / $4.23 / $7.15
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $6.81 / $6.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.55 / $6.50 / $9.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $5.15 / $8.10
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.23 / $5.41 / $6.19