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New Jersey rates for HCPCS A4375

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $14.13 / $20.89
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
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $25.70 / $35.48
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $11.22 / $24.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $12.02 / $18.62