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New Jersey 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
Facility
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $2.27 / $2.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $1.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.61 / $2.22
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.86 / $2.89 / $4.11
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.25 / $2.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.69 / $3.14