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Pennsylvania rates for HCPCS A4394

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fl oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $1.78 / $2.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $2.22 / $2.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $3.62 / $3.62
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $3.62 / $3.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $4.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $1.85 / $2.56
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $3.33 / $4.90
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.15 / $2.52 / $2.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $1.78 / $2.82
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $2.22 / $3.17
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $5.20 / $7.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $4.25
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $1.85 / $4.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.59 / $3.45 / $3.45
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $3.45 / $3.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.81 / $3.25