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Missouri 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
$5.41 / $8.81 / $12.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.41 / $7.09 / $13.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.33 / $6.33 / $10.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $6.45 / $8.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.87 / $11.37 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $6.30 / $10.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.20 / $6.30 / $9.03