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New Hampshire rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Facilitymedian $5 · 10th–90th $5–$60%20%40%90th$5Professionalmedian $7 · 10th–90th $4–$120%20%10th90th$7$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
$4.79 / $4.79 / $5.75
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $12.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $4.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $7.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $5.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $14.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $3.09 / $3.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $5.25 / $7.94
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $17.38