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Pennsylvania rates for HCPCS A4388

Ostomy Pouch Drainable With Extended Wear Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $2.99 / $4.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $3.74 / $4.87
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.63 / $6.09 / $6.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $3.66 / $7.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.11 / $4.30
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $5.60 / $8.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.12 / $4.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $2.99 / $4.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $3.74 / $5.05
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.60 / $8.69 / $12.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $3.66 / $7.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.11 / $7.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.36 / $5.80 / $5.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.36 / $5.80 / $5.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.56 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $3.04 / $5.07