go back

Indiana rates for HCPCS A4392

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $9.77 / $11.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.30 / $7.25 / $9.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $5.73 / $11.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $7.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.57 / $12.56 / $17.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.71 / $12.56 / $15.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $7.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $6.86 / $11.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $5.45 / $8.07