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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
$3.98 / $5.75 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $9.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $10.23 / $14.45
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $12.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $11.75 / $13.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $4.37 / $4.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $8.13 / $12.59