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New Hampshire rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Facilitymedian $3 · 10th–90th $3–$40%20%40%90th$3Professionalmedian $4 · 10th–90th $2–$80%20%10th90th$4$2.0$5.0$10.0$20.0

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
$3.16 / $3.16 / $3.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $7.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $4.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $3.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $9.77
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $2.04 / $2.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $3.47 / $5.25
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $17.38