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Minnesota rates for HCPCS A4393

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.05 / $8.05 / $8.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.52 / $8.05 / $9.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $13.48 / $17.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.10 / $12.25 / $12.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $39.31 / $109.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $15.50 / $18.57
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.34 / $37.72 / $85.98
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $14.63 / $15.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.56 / $12.63 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.57 / $5.95 / $13.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.57 / $5.98 / $12.68