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New Mexico rates for HCPCS A4390

Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (one piece), each

Facilitymedian $9 · 10th–90th $4–$140%10%10th90th$9Professionalmedian $8 · 10th–90th $5–$110%20%10th90th$8$5.0$10.0$20.0$50.0

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
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.94 / $10.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.72 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $16.22
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $13.49 / $23.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $9.77 / $15.14
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $14.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.75 / $13.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $5.75 / $8.51