go back

New Jersey 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
$2.44 / $2.44 / $2.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $2.44 / $4.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.59 / $2.59
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 / $5.63
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.64 / $2.81 / $5.50
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.33 / $3.33 / $3.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.50 / $3.88