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West Virginia 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
$5.03 / $5.03 / $5.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.03 / $5.59 / $6.16
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $11.39 / $15.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $6.38 / $10.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.79 / $10.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $5.47 / $44.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.32 / $4.54 / $7.57