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New Hampshire rates for HCPCS A4361

Ostomy Faceplate Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.09 / $13.09 / $15.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.88 / $12.50 / $15.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.93 / $10.93 / $10.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.42 / $15.42 / $15.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $13.11 / $18.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.30 / $20.30 / $62.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.27 / $12.42 / $15.16
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.75 / $18.43 / $23.45