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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
$7.08 / $9.55 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.08 / $10.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $9.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $6.92 / $14.79
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $8.51 / $13.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $10.23 / $15.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $6.92 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $6.92
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $6.92 / $15.49
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $6.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $7.24 / $10.47
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $13.18 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $4.79 / $7.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $5.37 / $7.24