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Vermont rates for HCPCS A4392

Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $7.72 / $7.72
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 / $6.73 / $7.64
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $7.64
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $6.86 / $7.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.95 / $13.21