go back

Ohio rates for HCPCS A4391

Ostomy Pouch Urinary With Extended Wear Barrier Attached (1 Piece) Each (Updated 01-01-2003) Ch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.27 / $6.27 / $17.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $6.27 / $8.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.90 / $7.90 / $7.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $4.95 / $12.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.40 / $9.86 / $13.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.42 / $9.86 / $21.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $11.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.04 / $6.98
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $7.47
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.93 / $6.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.83 / $6.64 / $8.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.21 / $4.63 / $6.31