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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
$1.00 / $3.02 / $3.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $3.16 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $3.24
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $5.13 / $5.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $3.89 / $10.96