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Arizona rates for HCPCS A5057

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

Facilitymedian $12 · 10th–90th $4–$260%10%10th90th$12Professionalmedian $8 · 10th–90th $4–$110%10%20%10th90th$8$0.1$0.5$2.0$10.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.94 / $10.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $6.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $13.49 / $25.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $12.30 / $23.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $8.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $10.72 / $26.92
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $5.75 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $5.25 / $8.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.75 / $8.71