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Arkansas rates for HCPCS A5056

Ostomy pouch, drainable, with extended wear barrier attached, with filter, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.26 / $5.26 / $5.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.84 / $5.26 / $5.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.13 / $4.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.28 / $8.28 / $8.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.53 / $6.53 / $8.16
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.53 / $6.53 / $8.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.93 / $3.93 / $4.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $3.93 / $4.62
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $3.01 / $4.38