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New Mexico rates for HCPCS A4388

Ostomy pouch, drainable, with extended wear barrier attached, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $3.98 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $32.36 / $54.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $4.90 / $5.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $9.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $6.17 / $10.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $4.57 / $6.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $7.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $6.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $2.57 / $3.89