go back

Massachusetts rates for HCPCS A4377

Ostomy Pouch Drainable For Use On Faceplate Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.62 / $2.62 / $2.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $2.62 / $4.54
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.04 / $17.05 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $4.04 / $5.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $4.09 / $12.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $4.26 / $4.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.27 / $3.60 / $4.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $7.13
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
$4.88 / $4.88 / $5.12
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.16 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.99 / $5.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.99 / $5.99