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Missouri 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
$3.98 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.08 / $13.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $6.03 / $10.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $6.92 / $11.75
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 / $7.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $9.77 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.75 / $56.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $4.47 / $7.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.50 / $8.13