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Hawaii 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
$3.02 / $3.98 / $6.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $7.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $8.32 / $11.75
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $9.55 / $10.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $9.55 / $10.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $3.39 / $3.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $6.76 / $10.23