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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$1.11 / $1.56 / $2.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.34 / $7.22 / $8.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.99 / $3.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $1.88 / $3.14