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Washington, DC 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
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $7.94 / $10.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $9.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $6.92 / $8.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $26.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $6.76 / $11.75