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Iowa 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
$5.81 / $5.81 / $6.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $5.79 / $7.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.47 / $10.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.79 / $10.02 / $13.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.11 / $10.02 / $14.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.22 / $10.59 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $4.59 / $12.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.99 / $10.02 / $12.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.83 / $11.08 / $19.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.32 / $4.54 / $11.84
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.19 / $8.19 / $8.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.48 / $8.19 / $8.19