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New Hampshire rates for HCPCS A5072

Ostomy Pouch Urinary; Without Barrier Attached (1piece) Each (Updated 01-01-2003) 30)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.59 / $2.59 / $3.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.42 / $2.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $2.46 / $2.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $2.86 / $2.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.43 / $3.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $12.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.46 / $3.97
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.32 / $3.65 / $4.65