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Hawaii rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $3.16 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $4.68 / $6.61
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $5.37 / $5.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $5.37 / $6.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $2.00 / $2.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.72 / $5.75