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Kansas 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
$14.81 / $14.81 / $14.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $7.15 / $14.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.17 / $11.76 / $12.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.35 / $12.35 / $12.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $19.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.68 / $11.60 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.70 / $17.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.29 / $6.32 / $8.58