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Maine rates for HCPCS A4358

Urinary Drainage Bag Leg Or Abdomen Vinyl With Or Without Tube With Straps Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $4.75 / $4.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.34 / $5.57 / $6.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $4.73 / $6.36
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.54 / $7.54 / $7.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $4.75 / $5.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $4.54 / $9.17