go back

Illinois rates for HCPCS A4393

Ostomy Pouch Urinary With Extended Wear Barrier Attached With Built-In Convexity (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.09 / $7.09 / $7.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $7.09 / $12.62
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.21 / $8.21 / $8.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.07 / $33.96 / $110.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.58 / $9.47 / $9.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $13.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $7.59 / $14.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.63 / $15.46 / $25.89
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.42 / $16.42 / $16.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.02 / $15.79 / $18.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $6.30 / $13.13