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Ostomy Pouch

		

Details: Extended Wear Barrier With Built-in Convexity. A4390 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.



Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?




               

               


                    

                    

                    

                    

                         

                    

               

               

          

          
          
          

               

               

               

               

                    

                         

                              

                                   
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                                   		 Facility     
                                   City/State                                 
                                   
                                        Average Cost Range     
                                     
                                   
                                                                                                                                                                
                              

                         
                        
                         

                         

                         

                         
                               
                                   

                                         
                                        Sanford HealthCare  Accessories
                                        Fargo, ND
                                        $9.79 - $10.74
                                         
                   
                                   

                             
                                   

                                         
                                        Handi Medical Supply
                                        Saint Paul, MN
                                        $9.79 - $10.74
                                         
                   
                                   

                             
                                   

                                         
                                        Edgepark Medical Supplies
                                        Twinsburg, OH
                                        $9.79 - $10.74
                                         
                   
                                   

                                                               
                              


                         

                    





                    

               


               

                    
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