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New Hampshire rates for HCPCS A4383

Ostomy pouch, urinary, for use on faceplate, rubber, each

Facilitymedian $21 · 10th–90th $21–$250%20%40%90th$21Professionalmedian $28 · 10th–90th $19–$520%20%10th90th$28$10.0$20.0$50.0$100.0

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
$20.89 / $20.89 / $25.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.88 / $52.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $22.39 / $26.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $13.18 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $22.39 / $34.67
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $52.48