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Hawaii rates for HCPCS A4435

Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.07 / $4.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.81 / $6.81 / $6.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.70 / $5.70 / $9.42
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.99 / $8.56 / $11.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $8.00 / $9.42
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.91 / $7.14 / $8.15