go back

Oklahoma 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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $7.94 / $10.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $8.13 / $8.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $6.92 / $14.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $9.33 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.46 / $16.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.47 / $5.25 / $13.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.75 / $8.13