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Rhode Island 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
$2.67 / $3.76 / $5.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.87 / $17.41 / $20.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.78 / $8.01
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 / $5.47 / $5.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.27 / $4.54 / $7.57