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Arkansas rates for HCPCS A5057

Ostomy Pouch Drainable With Extended Wear Barrier Attached With Built In Convexity With Filter (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.81 / $10.81 / $10.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $10.81 / $10.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.52 / $8.52 / $8.52
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
$17.03 / $17.03 / $17.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.41 / $13.41 / $16.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.41 / $13.41 / $17.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $9.49
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.81 / $9.81 / $9.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.11 / $8.26