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North Carolina 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
$11.75 / $11.75 / $14.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.50 / $11.75 / $11.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.23 / $17.84 / $24.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.13 / $10.06 / $10.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $15.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.68 / $11.75 / $15.38
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.00 / $9.00 / $9.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.10 / $16.10 / $24.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.37 / $9.71
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.78 / $66.78 / $100.58