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Maine rates for HCPCS A4415

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 in, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $16.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $6.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.68 / $5.01 / $6.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $5.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $8.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.25 / $16.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $3.24 / $3.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $4.37 / $7.59