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Rhode Island rates for HCPCS A4390

Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.94 / $5.54 / $8.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.98 / $25.61 / $30.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $7.06 / $11.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.53 / $9.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $8.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $6.70 / $11.16