go back

Indiana rates for HCPCS A4391

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.46 / $8.46 / $9.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.45 / $6.27 / $8.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $4.95 / $9.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $4.95 / $6.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.40 / $10.86 / $14.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.39 / $10.86 / $13.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $6.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.93 / $10.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $4.71 / $6.65