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New Mexico rates for HCPCS A4391

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.18 / $7.18 / $7.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $7.01 / $28.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $7.89 / $9.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $5.93 / $5.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.93 / $6.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.89 / $9.86 / $14.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.70 / $2.70 / $7.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $6.98 / $11.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.84 / $4.19 / $6.31