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North Carolina 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
$10.00 / $10.00 / $12.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.55 / $10.00 / $10.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.41 / $15.19 / $20.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.95 / $8.57 / $9.14
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 / $13.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $10.00 / $13.09
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $8.22
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.70 / $13.70 / $21.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.42 / $8.06
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.87 / $56.87 / $85.65