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New Hampshire rates for HCPCS A4412

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), without filter, each

Facilitymedian $2 · 10th–90th $2–$20%20%40%90th$2Professionalmedian $3 · 10th–90th $1–$50%20%10th90th$3$1.0$2.0$5.0$10.0

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
$2.00 / $2.00 / $2.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $5.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $2.34
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $3.31 / $6.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.26 / $1.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $2.14 / $3.31
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $17.38