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Louisiana 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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.08 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $16.98 / $23.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $11.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $4.47 / $5.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $5.37 / $6.92