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New Hampshire 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
$2.00 / $2.00 / $2.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $1.87 / $2.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $2.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.12 / $3.12 / $9.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.90 / $2.31
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $2.83 / $3.60