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Delaware 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
Professional
Modifier
Low / Median / High Price
$7.07 / $8.23 / $11.74
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 / $6.86 / $8.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.70 / $10.32