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Hawaii rates for HCPCS A4419

Ostomy pouch, closed; for use on barrier with nonlocking flange, with filter (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $1.19 / $1.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.93 / $1.93 / $1.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $2.65 / $2.65
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.52 / $2.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $2.41 / $3.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.93 / $2.65
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.00 / $2.29