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Maryland rates for HCPCS A4419

Ostomy pouch, closed; for use on barrier with nonlocking flange, with filter (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.66 / $1.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.45 / $3.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.93 / $1.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.20 / $1.91
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $2.04