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Alaska rates for HCPCS A4392

Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $7.94 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $7.08
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $10.96 / $10.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $11.75 / $37.15
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $11.22 / $11.22
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $11.22 / $14.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $3.16 / $12.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $8.51 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $4.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $23.44