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South Carolina rates for HCPCS A4390

Ostomy Pouch Drainable With Extended Wear Barrier Attached With Built-In Convexity (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.73 / $10.73 / $10.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.93 / $10.73 / $11.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.50 / $7.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.60 / $16.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.18 / $8.07 / $8.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $9.49
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.51 / $11.53 / $21.07
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.00 / $9.00 / $9.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.06 / $9.06 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.05 / $8.58