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New York rates for HCPCS A4393

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $6.17 / $11.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $6.17 / $11.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.33 / $8.28 / $16.66
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $10.52 / $10.52
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.52 / $10.52 / $10.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $6.45 / $8.93
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.63 / $28.42 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $9.09 / $22.36
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.57 / $9.57 / $9.57
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.13 / $9.13 / $10.52
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.09 / $8.09 / $8.09
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $7.74 / $18.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.20 / $6.30 / $10.74
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.03 / $9.13 / $9.13
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.13 / $9.13 / $9.57