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New Jersey rates for HCPCS A4416

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $1.88 / $1.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.18 / $1.88 / $3.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $2.72
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.35 / $4.24
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $2.56 / $2.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.92 / $3.01