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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
$15.78 / $15.78 / $18.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.12 / $15.78 / $18.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.93 / $15.93 / $15.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.60 / $21.22 / $21.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.04 / $18.04 / $27.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.48 / $24.48 / $75.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.98 / $14.98 / $18.28
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.20 / $22.22 / $28.28