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New Mexico rates for HCPCS A4394

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fl oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $2.63 / $2.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.57 / $10.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.90 / $3.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $2.18 / $2.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $5.31 / $7.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.99 / $0.99 / $2.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $2.56 / $4.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.54 / $2.29