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West Virginia 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
$6.30 / $6.30 / $6.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.30 / $7.00 / $7.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.42 / $15.42 / $19.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.42 / $7.99 / $13.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $7.64 / $13.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $6.86 / $55.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $5.69 / $9.49