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Vermont rates for HCPCS A4377

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $3.89 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.63
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $5.89 / $6.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $2.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $3.63 / $12.59