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Kentucky rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.98 / $6.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $4.57 / $7.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $3.89 / $4.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $10.47 / $13.49
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $9.55 / $12.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $12.30 / $12.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $6.03 / $37.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.61 / $10.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $3.02 / $3.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $3.63 / $4.90