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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
$11.73 / $11.73 / $11.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.35 / $11.73 / $19.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $16.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $15.93
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.93 / $22.07 / $31.43
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.11 / $15.96 / $15.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $11.97 / $22.02