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Pennsylvania 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
$3.20 / $3.20 / $5.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $4.00 / $5.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.53 / $6.53 / $6.53
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.98 / $6.53 / $6.53
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 / $4.62
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.01 / $6.53 / $12.41
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.40 / $4.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.20 / $3.20 / $5.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $4.00 / $6.18
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.10 / $9.30 / $12.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.93 / $3.93 / $4.16
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $3.34 / $7.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.66 / $6.22 / $6.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.66 / $6.22 / $6.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $3.26 / $5.71