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New Hampshire rates for HCPCS A4355

Irrigation Tubing Set For Continuous Bladder Irrigation Through A Three-Way Indwelling Foley Catheter Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.57 / $5.57 / $6.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.63 / $5.57 / $6.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.35 / $5.35 / $5.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $8.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.64 / $8.64 / $26.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.52 / $5.29 / $6.43
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $8.32 / $13.49