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Hawaii rates for HCPCS A4391

Ostomy pouch, urinary, with extended wear barrier attached (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $4.90 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $5.89 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $9.55 / $13.49
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $11.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $10.96 / $12.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.24 / $3.80 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $7.59 / $11.75