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Hawaii rates for HCPCS A4393

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.03 / $10.03 / $10.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.93 / $8.93 / $13.89
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.63 / $13.23 / $13.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.84 / $12.63 / $17.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.30 / $10.03 / $13.89
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.33 / $10.18 / $12.02