go back

New Hampshire rates for HCPCS A4411

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $3.72 / $4.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.98 / $8.91
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.55 / $3.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.63 / $4.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $10.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $2.40 / $2.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.55 / $6.17
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $4.79 / $7.59