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Maryland rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $15.14 / $21.38
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.49 / $13.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $24.55 / $36.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $9.33 / $15.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $12.02 / $19.05
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $20.42