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West Virginia 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
$4.79 / $4.79 / $4.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.32 / $5.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $11.70 / $15.17
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $6.07 / $10.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.22 / $5.78 / $10.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $5.22 / $41.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.17 / $4.33 / $7.78