go back

Pennsylvania rates for HCPCS A4395

Ostomy deodorant for use in ostomy pouch, solid, per tablet

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05
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
$0.04 / $0.05 / $0.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.04
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.10
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.05
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.05
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $0.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.06
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05