go back

New Mexico rates for HCPCS A4392

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.94 / $10.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $9.12 / $10.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $16.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $11.75 / $19.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $8.51 / $12.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $13.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $4.47 / $11.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.79 / $7.24