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North Dakota 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
$9.77 / $9.77 / $9.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.91 / $8.56 / $9.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.54 / $14.82 / $15.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.38 / $15.53 / $19.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.54 / $9.77 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.22 / $6.32 / $13.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $9.49 / $13.41