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Georgia rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.77 / $5.77 / $5.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.77 / $7.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.23 / $5.23 / $5.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.55 / $7.57 / $16.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.25 / $7.74 / $14.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.74 / $7.74 / $7.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.47 / $5.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $4.65 / $10.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $9.11 / $16.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $4.28 / $7.49