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Maryland rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.36 / $4.87 / $6.74
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.20 / $5.20 / $5.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $4.62 / $5.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.93 / $3.93 / $5.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.39 / $7.70 / $11.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $3.84 / $6.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.85 / $3.85 / $5.39