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Maine 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
$1.37 / $2.87 / $2.87
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 / $3.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $3.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.08 / $4.08 / $4.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.87 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.50 / $5.74