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Tennessee 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
$3.98 / $5.01 / $7.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $7.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.46 / $6.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.47 / $5.25
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $64.57 / $64.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $3.39 / $4.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $4.07 / $5.13