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New Hampshire rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Facilitymedian $3 · 10th–90th $3–$30%20%40%90th$3Professionalmedian $4 · 10th–90th $2–$70%20%10th90th$4$2.0$5.0$10.0$20.0

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
$2.75 / $2.75 / $3.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.75 / $7.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.75
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $4.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $8.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.74 / $2.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $2.95 / $4.57
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $17.38