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Connecticut rates for HCPCS A4425

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $3.22 / $3.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $2.56
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.81 / $3.25 / $3.25
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $3.50 / $4.59
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.00 / $57.00 / $57.00
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $2.38 / $3.10