go back

North Carolina 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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $6.03 / $7.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $11.75 / $12.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.61 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.47 / $10.23
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.37 / $6.17
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $7.59 / $12.59
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $3.39 / $5.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $4.17 / $6.17
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $85.11
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $64.57