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New Jersey 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
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.01 / $5.01 / $7.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.86 / $4.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.18 / $6.18 / $6.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $7.06
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.32 / $6.72 / $10.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.84 / $6.84 / $6.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.13 / $7.91