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New Mexico rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Facilitymedian $60 · 10th–90th $10–$2000%10%10th90th$60Professionalmedian $14 · 10th–90th $10–$200%20%10th90th$14$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.14 / $19.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $128.82 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $29.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $41.69
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $18.20 / $28.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $25.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $10.23 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $10.23 / $15.49