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Idaho 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
Professional
Modifier
Low / Median / High Price
$5.16 / $12.37 / $12.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.47 / $5.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $4.65 / $6.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.49 / $6.31 / $12.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $8.65 / $9.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $9.11 / $17.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $9.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $3.67 / $6.51