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New Hampshire rates for HCPCS A5055

Stoma cap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.97 / $1.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.99 / $0.99 / $0.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.03 / $1.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $1.64 / $5.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $1.00 / $1.22
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.49 / $1.89