go back

Nebraska 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
$7.19 / $7.19 / $7.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.19 / $7.19 / $7.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.62 / $8.39 / $8.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $9.53 / $9.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.22 / $9.53 / $14.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.34 / $8.67 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.05 / $4.33 / $8.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.52 / $9.53 / $12.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.82 / $11.15 / $18.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $4.33 / $5.68