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Missouri 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
$3.90 / $6.35 / $9.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.90 / $5.12 / $10.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.55 / $4.55 / $7.49
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 / $5.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.23 / $8.19 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $4.54 / $7.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $4.54 / $6.51