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Tennessee 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
$5.09 / $5.09 / $6.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.30 / $6.25 / $8.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $8.88 / $8.88
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 / $5.04 / $6.98
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.04 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.15 / $49.15 / $74.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.15 / $4.59 / $6.01