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New York 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
$4.97 / $5.58 / $10.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.58 / $10.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $7.56 / $15.27
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.84 / $9.51 / $9.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.51 / $9.51 / $9.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $7.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $5.83 / $8.07
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.42 / $25.70 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.74 / $8.22 / $20.21
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.67 / $8.67 / $8.67
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.26 / $8.26 / $9.51
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.33 / $9.33
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $7.00 / $16.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $5.69 / $9.84
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.18 / $8.26 / $8.26
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.26 / $8.26 / $8.67