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Maryland rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $3.30 / $4.55
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.52 / $3.52 / $3.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $3.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $5.21 / $7.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $2.60 / $4.12
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $2.60 / $3.65