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Maryland 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
$3.80 / $5.49 / $7.60
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.88 / $5.88 / $5.93
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 / $6.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.07 / $8.67 / $12.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.12 / $4.33 / $6.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.34 / $4.34 / $6.07