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Vermont rates for HCPCS A4376

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $42.66 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $39.81
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $64.57 / $66.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $30.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $40.74 / $138.04