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New Mexico rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.66 / $1.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.45 / $1.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.36 / $1.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.04 / $3.07
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.67 / $1.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.36 / $2.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.03 / $1.56