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North Carolina 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
$8.65 / $8.65 / $10.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.25 / $8.65 / $8.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.99 / $14.65 / $18.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.72 / $7.40 / $7.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $6.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.93 / $11.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.70 / $8.65 / $11.31
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $7.33
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.80 / $11.80 / $18.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $4.69 / $7.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.15 / $49.15 / $74.03