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Vermont rates for HCPCS A4391

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.19 / $6.67 / $6.67
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 / $5.77 / $6.28
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $6.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.93 / $6.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $6.01 / $11.41