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Washington, DC rates for HCPCS A4412

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), without filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.56
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $1.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.50 / $7.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.76 / $2.67