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Massachusetts rates for HCPCS A4435

Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.53 / $3.53 / $3.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.53 / $3.53 / $6.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.42 / $17.96 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $5.42 / $7.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.03 / $5.37 / $5.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $4.84 / $4.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.84 / $9.38
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
$6.57 / $6.57 / $6.90
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.38 / $5.38 / $5.38
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.34 / $75.00 / $75.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.93 / $4.01 / $7.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.93 / $4.01 / $8.05