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New Hampshire rates for HCPCS A4398

Ostomy Irrigation Supply; Bag Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.46 / $9.46 / $11.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.27 / $9.46 / $11.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.67 / $9.67 / $9.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.60 / $11.60 / $14.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.86 / $9.86 / $13.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.47 / $15.47 / $47.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.98 / $8.97 / $11.53
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $14.03 / $17.85