go back

Alaska rates for HCPCS A4389

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $6.03 / $10.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.47 / $5.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.40 / $2.40 / $8.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.91 / $28.84
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $8.51 / $8.51
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $8.51 / $10.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.40 / $2.40 / $9.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $6.46 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $2.95 / $3.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $4.37 / $17.78