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New Jersey rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.93 / $2.93 / $2.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $2.93 / $4.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $4.23
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.49 / $5.51 / $7.85
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.33 / $2.99 / $5.50