go back

Arizona 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
$2.37 / $5.20 / $7.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $8.27 / $14.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.72 / $7.63 / $10.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $5.22 / $5.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $4.44 / $6.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.38 / $6.22 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.94 / $3.68 / $5.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.12 / $3.68 / $5.55