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West Virginia 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
$1.73 / $1.73 / $1.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.93 / $2.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $4.24 / $5.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.20 / $3.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $4.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.89 / $15.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $2.61 / $5.01