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Maine rates for HCPCS A4377

Ostomy Pouch Drainable For Use On Faceplate Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $3.44 / $3.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $4.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.20 / $4.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $4.88 / $4.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.15 / $3.44 / $4.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.99 / $6.89