go back

Vermont 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
$1.46 / $3.52 / $3.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.22 / $4.22 / $4.22
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 / $2.88 / $3.60
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.13 / $3.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $3.16 / $6.01