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Connecticut rates for HCPCS A4390

Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.63 / $8.63 / $8.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $8.63 / $9.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $8.07
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.96 / $8.72 / $8.72
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.96 / $9.39 / $12.34
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.63 / $7.63 / $7.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.11 / $6.19 / $8.32