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Maine 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
$0.67 / $1.39 / $1.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $1.97 / $1.97
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $1.38 / $1.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.21 / $2.78