go back

New Mexico rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.59 / $5.59 / $5.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $5.46 / $22.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.16 / $37.43 / $67.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.61 / $6.15 / $7.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $4.62 / $4.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.93 / $4.62 / $5.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.16 / $7.70 / $11.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $5.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.93 / $5.44 / $9.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.99 / $3.26 / $4.91