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Pennsylvania 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
$1.00 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.31
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $3.89 / $3.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $6.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $2.45
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $4.37 / $7.41
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $3.89 / $3.89
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $2.75 / $3.89
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $2.88 / $2.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.02
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.63
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $5.25 / $7.59
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $2.75 / $7.94
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $3.63 / $7.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.62 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.91 / $3.47