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Wyoming 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
$3.92 / $3.92 / $7.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.90 / $8.90 / $8.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.90 / $8.90 / $8.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $5.47 / $10.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $4.65 / $5.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $3.86 / $4.28