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New Hampshire rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Facilitymedian $3 · 10th–90th $2–$30%20%40%10th90th$3Professionalmedian $3 · 10th–90th $1–$40%20%10th90th$3$1.0$2.0$5.0$10.0

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
$2.51 / $2.51 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $2.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $2.75 / $5.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.07 / $1.23 / $2.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $2.63 / $3.16
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.17 / $4.17 / $17.38