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New Hampshire rates for HCPCS A4423

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.27 / $1.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.56 / $1.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.12 / $6.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.30 / $1.58
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $1.93 / $2.45