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West Virginia 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
$6.97 / $6.97 / $6.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $7.74 / $8.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.21 / $15.79 / $22.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.21 / $8.84 / $15.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $8.03 / $14.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $7.59 / $61.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.61 / $6.33 / $10.50