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New York 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
$1.68 / $1.88 / $3.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.89 / $3.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.54 / $5.07
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $3.21 / $3.21
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.21 / $3.21 / $3.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $2.72
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.85 / $8.66 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.77 / $6.81
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.64 / $2.64 / $2.64
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.64 / $2.78 / $3.17
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.36 / $5.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.92 / $3.47
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $2.78 / $2.78
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.64 / $2.78 / $2.78