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Nebraska 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
$8.18 / $8.18 / $8.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.18 / $8.18 / $8.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.67 / $9.52 / $9.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $10.86 / $10.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.93 / $10.86 / $16.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.48 / $9.86 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $4.93 / $8.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.83 / $10.86 / $13.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.89 / $12.69 / $21.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $4.73 / $6.45