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Ohio 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
$7.25 / $7.25 / $20.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.58 / $7.25 / $9.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.14 / $9.14 / $9.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $14.84
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.42 / $11.42 / $11.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.57 / $11.42 / $15.42
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.42 / $11.42 / $24.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.43 / $6.86 / $13.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $5.83 / $8.07
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.43 / $6.86 / $7.64
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $6.86 / $7.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.07 / $6.97 / $9.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $5.37 / $7.29