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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
$4.88 / $7.97 / $11.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $6.41 / $12.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $9.40
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 / $5.83 / $7.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $10.28 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $5.69 / $9.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.69 / $8.18