go back

Maine rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $2.21 / $2.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $1.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $3.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $2.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $3.14 / $3.14
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $2.21 / $2.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.92 / $4.42