go back

Iowa 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
$2.00 / $2.00 / $2.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $2.27 / $2.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $3.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $3.75 / $4.69
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $4.53 / $5.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $4.44 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.38 / $4.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.45 / $3.45 / $4.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $4.08 / $6.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.58 / $4.08
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.83 / $2.83 / $2.83
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.83 / $2.83