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New Mexico rates for HCPCS A4435

Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.07 / $12.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $14.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $5.75 / $9.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.07 / $9.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.09 / $3.39 / $8.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $3.39 / $5.37