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Vermont 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
$2.02 / $2.60 / $2.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.11 / $3.11
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 / $2.31 / $2.45
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.45
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.38 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $2.34 / $4.45