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Kentucky 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
$4.44 / $6.90 / $7.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $7.92 / $11.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $7.21
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.72 / $18.77 / $22.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.74 / $16.09 / $22.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $15.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.31 / $64.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.88 / $9.61 / $17.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $6.32 / $8.58