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Massachusetts rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.49 / $10.49 / $10.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.49 / $10.49 / $18.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.14 / $68.34 / $113.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.36 / $16.14 / $23.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.38 / $16.38 / $48.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.16 / $17.05 / $17.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.10 / $15.93 / $18.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $27.75
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
$19.55 / $19.55 / $20.54
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.47 / $11.47 / $11.47
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.70 / $113.95 / $113.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $11.97 / $23.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.14 / $11.97 / $23.99