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
$7.99 / $7.99 / $9.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.94 / $7.87 / $7.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.59 / $11.75 / $11.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $10.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.68 / $8.39 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.40 / $13.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.69 / $8.17