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New Mexico rates for HCPCS A5063

Ostomy pouch, drainable; for use on barrier with flange (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.68 / $10.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.02 / $25.80 / $48.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $3.02 / $3.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.43 / $5.54 / $8.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $1.04 / $2.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.67 / $4.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.60 / $2.41