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Maine rates for HCPCS A4387

Ostomy Pouch Closed With Barrier Attached With Built-In Convexity (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $2.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $4.20 / $4.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $4.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.89 / $2.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.56
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $2.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $2.22 / $3.60