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New Hampshire rates for HCPCS A5073

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $2.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.94 / $2.18 / $2.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.13 / $2.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $2.67 / $3.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.27 / $3.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.62 / $3.62 / $11.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.21 / $2.54
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.99 / $3.29 / $4.19