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Georgia 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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.94 / $10.96
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $11.22 / $17.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $8.13 / $21.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $6.92 / $15.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $13.80 / $17.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $5.25 / $7.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $6.46 / $11.75