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New Hampshire rates for HCPCS A4393

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

Facilitymedian $7 · 10th–90th $7–$80%20%40%90th$7Professionalmedian $10 · 10th–90th $6–$170%20%10th90th$10$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
$6.61 / $6.61 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $16.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $6.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $10.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $7.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $20.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $4.27 / $5.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $7.24 / $10.96
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $16.60