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New Hampshire rates for HCPCS A4314

Insertion tray with drainage bag with indwelling catheter, Foley type, two-way latex with coating (Teflon, silicone, silicone elastomer or hydrophilic, etc.)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $18.20 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $21.38 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $21.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $45.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $11.75 / $17.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $15.14 / $26.30
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $32.36