go back

New Mexico rates for HCPCS A4377

Ostomy Pouch Drainable For Use On Faceplate Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.34 / $4.34 / $4.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $4.24 / $17.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.60 / $4.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.99 / $8.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.64 / $4.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $4.23 / $7.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.33 / $2.54 / $3.83