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Connecticut rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $15.14 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.49 / $13.49
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $17.78 / $23.99
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $15.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $12.02 / $16.22