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North Dakota 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
$6.32 / $6.32 / $6.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $5.53 / $6.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.11 / $9.59 / $9.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.13 / $10.23 / $12.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.23 / $6.32 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $4.09 / $8.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $3.68 / $8.67