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Oklahoma 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
$6.80 / $6.80 / $8.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.70 / $6.70 / $6.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.81 / $10.00 / $10.00
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 / $8.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $7.14 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $5.45 / $11.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $4.84 / $6.95