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New Mexico rates for HCPCS A4423

Ostomy pouch, closed; for use on barrier with locking flange, with filter (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $1.88 / $1.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $1.84 / $7.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $2.06 / $2.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.56 / $1.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.56 / $1.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.07 / $2.59 / $3.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $1.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.84 / $3.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.10 / $1.66