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New Mexico rates for HCPCS A5054

Ostomy pouch, closed; for use on barrier with flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.78 / $7.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $2.00 / $2.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.51 / $1.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.50 / $3.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.68 / $1.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.78 / $2.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.07 / $1.60