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West Virginia 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
$2.09 / $2.09 / $2.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.31 / $2.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $5.09 / $6.62
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $2.65 / $4.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.80 / $8.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $18.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $1.88 / $3.14