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Georgia 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
$5.49 / $5.49 / $5.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.49 / $6.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $5.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.34 / $7.22 / $16.51
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.37 / $8.67 / $16.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.37 / $7.37 / $7.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $5.22 / $5.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $4.44 / $9.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.59 / $8.67 / $15.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $4.15 / $7.15