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North Carolina 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
$11.06 / $11.06 / $13.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $11.06 / $11.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.50 / $16.80 / $23.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.59 / $9.47 / $10.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $7.59 / $14.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $11.06 / $14.46
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.41
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.20 / $15.20 / $23.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $6.00 / $9.07
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.90 / $62.90 / $94.73