go back

Louisiana 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
$5.22 / $6.43 / $6.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.22 / $6.43 / $7.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.69 / $8.69 / $8.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.92 / $13.54 / $19.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.40 / $6.47 / $6.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.47 / $6.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $4.65 / $6.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $4.19 / $5.94