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Georgia rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $2.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.63 / $4.37
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $2.69 / $2.69
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $2.69 / $2.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $1.91 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $2.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $3.24 / $5.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.78 / $3.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.78 / $3.98