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New Hampshire rates for HCPCS A4391

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

Facilitymedian $5 · 10th–90th $5$60%20%40%90th$5Professionalmedian $7 · 10th–90th $4$130%20%10th90th$7$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
$5.25 / $5.25 / $6.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.25 / $12.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $4.90 / $5.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $7.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $6.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $15.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $3.31 / $3.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $5.62 / $8.71
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $13.18