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Vermont 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
$4.04 / $5.19 / $5.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.23 / $6.23 / $6.23
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 / $4.32 / $5.71
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $4.62 / $5.71
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.93 / $4.32 / $5.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $4.68 / $8.89