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Missouri 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
$2.80 / $4.55 / $6.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $3.98 / $7.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $4.57 / $4.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $3.23 / $5.65
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 / $3.34 / $4.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.94 / $5.91 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $3.26 / $5.45
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.26 / $5.26 / $5.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $3.26 / $5.01