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New Mexico rates for HCPCS A4367

Ostomy Belt Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.91 / $6.91 / $6.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $7.21 / $28.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.58 / $69.31 / $129.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.08 / $8.11 / $9.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.18 / $6.18 / $6.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.18 / $7.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.90 / $14.88 / $22.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.81 / $2.81 / $7.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $7.06 / $11.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.03 / $4.36 / $6.56