go back

Idaho rates for HCPCS A4390

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.60 / $18.21 / $18.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $9.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.68 / $9.28 / $18.21
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.07 / $12.74 / $13.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.66 / $13.41 / $26.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.39 / $9.39 / $14.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.17 / $5.42 / $9.61