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New York 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
$3.51 / $4.07 / $7.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $4.16 / $7.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.16 / $4.16 / $11.98
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.24 / $6.71 / $6.71
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.71 / $6.71 / $6.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $4.84 / $4.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.12 / $5.99
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.05 / $18.11 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $6.32 / $14.73
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.32 / $6.32 / $6.32
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.05 / $5.37 / $6.71
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $4.84 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.84 / $11.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.68 / $4.01 / $6.94
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $5.05 / $5.05
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.05 / $5.05 / $6.32