go back

Wisconsin rates for HCPCS A4430

Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $7.08 / $10.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $12.02 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $11.22 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $37.15 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $17.38 / $22.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $10.00 / $17.38
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $22.91 / $28.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $12.02 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $6.03 / $13.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $18.20 / $31.62
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $23.99 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $13.18 / $58.88
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.02
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $5.01 / $7.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.89 / $9.77