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Maryland 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
Professional
Modifier
Low / Median / High Price
$2.19 / $3.17 / $4.38
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $3.38 / $3.42
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $5.00 / $7.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.50 / $3.96
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $3.50