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New Mexico rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.45 / $3.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $5.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.89 / $6.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $2.88 / $4.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $4.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.48 / $1.51 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.62 / $2.45