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Washington, DC rates for HCPCS A4389

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $5.86 / $5.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $5.86 / $5.86
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.88 / $5.88 / $5.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $4.44 / $4.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.22 / $17.22 / $17.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $4.33 / $6.35