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Kentucky rates for HCPCS A4417

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $2.68 / $3.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $3.08 / $4.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $2.60 / $2.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.91 / $7.29 / $8.60
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.17 / $6.25 / $8.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $6.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.22 / $25.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.05 / $3.72 / $6.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.35 / $3.32