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Connecticut rates for HCPCS A4391

Ostomy Pouch Urinary With Extended Wear Barrier Attached (1 Piece) Each (Updated 01-01-2003) Ch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.36 / $6.36 / $6.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.30 / $6.36 / $7.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $4.95 / $4.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $6.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.04 / $5.93
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.42 / $6.42 / $7.49
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.42 / $6.91 / $9.08
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.15 / $5.15 / $5.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.76 / $4.78 / $6.12