go back

New Jersey rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $3.39 / $4.68
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.09 / $2.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.07 / $2.19 / $3.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.91 / $3.24