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New Jersey 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
$4.82 / $4.82 / $4.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $4.82 / $8.18
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 / $6.98
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.05 / $7.49 / $10.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.57 / $6.57 / $6.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.84 / $4.93 / $7.68