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Washington, DC rates for HCPCS A5057

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.77 / $8.77 / $9.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $6.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.63 / $26.63 / $26.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.24 / $9.49