go back

New Hampshire rates for HCPCS A4419

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.29
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 / $1.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.09 / $3.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.81 / $0.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.20 / $2.09
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $2.63