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New Hampshire rates for HCPCS A4376

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

Facilitymedian $35 · 10th–90th $35–$420%20%40%90th$35Professionalmedian $47 · 10th–90th $32–$890%20%10th90th$47$5.0$10.0$20.0$50.0$100.0$200.0

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
$34.67 / $34.67 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $40.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $22.39 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $38.02 / $57.54
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $89.13