go back

Massachusetts rates for HCPCS A4367

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.04 / $4.04 / $4.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $4.04 / $6.93
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.53 / $20.87 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.92 / $6.72 / $9.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.97 / $5.97 / $17.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $6.57 / $6.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.67 / $6.50 / $6.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.18 / $12.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.53 / $7.53 / $7.91
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $5.86 / $5.86
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.87 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $4.61 / $9.02
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.91 / $5.91 / $6.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.61 / $5.13 / $9.02