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Tennessee 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
$6.93 / $6.93 / $8.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $8.50 / $11.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $12.07 / $12.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $9.49
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.22 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.78 / $66.78 / $100.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.86 / $6.24 / $8.14