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West Virginia rates for HCPCS A4425

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.76 / $2.76 / $2.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $3.07 / $3.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $6.00 / $7.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $6.00 / $11.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.19 / $5.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $24.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $2.50 / $4.30