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Connecticut rates for HCPCS A4391

Ostomy pouch, urinary, with extended wear barrier attached (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $6.03 / $7.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $8.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $5.89 / $6.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $6.46 / $7.41
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $7.24 / $9.77
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.13 / $5.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.47 / $4.47 / $6.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $4.90 / $6.76