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New York rates for HCPCS A4425

Ostomy pouch, drainable; for use on barrier with nonlocking flange, with filter (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.44 / $4.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.44 / $4.73
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $2.88 / $2.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $3.14 / $6.59
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.88 / $4.17 / $4.17
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $3.54
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.00 / $11.25 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.64 / $3.60 / $8.85
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.56 / $3.56 / $3.56
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $3.62 / $4.17
Fidelis
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.36 / $3.36 / $3.36
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.21 / $3.21 / $3.21
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $3.07 / $7.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.50 / $4.30
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.58 / $3.62 / $3.62
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $3.62 / $3.62