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Hawaii 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
$5.58 / $5.58 / $5.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.08 / $9.08 / $9.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.07 / $8.07 / $12.56
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.42 / $11.96 / $11.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.99 / $11.42 / $15.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.07 / $9.08 / $12.56
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $9.19 / $10.87