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Massachusetts rates for HCPCS A4426

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $1.67 / $1.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $1.67 / $2.89
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $10.85 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $2.57 / $3.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.71 / $2.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $3.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.29 / $4.50
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.12 / $3.12 / $3.28
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $1.89 / $1.89
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.73 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.34 / $1.90 / $3.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $1.90 / $3.72