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Maine rates for HCPCS A4367

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.04 / $5.90 / $5.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.67 / $6.18 / $7.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $7.06
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.53 / $7.53 / $7.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.18 / $5.90 / $7.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.42 / $5.13 / $14.23