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New Hampshire rates for HCPCS A4424

Ostomy pouch, drainable, with barrier attached, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.49 / $3.49 / $4.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $3.26 / $3.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.33 / $3.33 / $3.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.40 / $3.40 / $4.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.42 / $5.42 / $16.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $3.32 / $5.36
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.92 / $6.26