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Hawaii rates for HCPCS A5056

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.18 / $5.18 / $5.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $4.62 / $7.18
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.53 / $6.84 / $6.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $6.53 / $9.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.26 / $6.46 / $8.15
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.26 / $5.44 / $6.22