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Massachusetts 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
$5.86 / $5.86 / $5.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $6.71 / $10.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.02 / $29.46 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.24 / $9.02 / $13.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.32 / $10.32 / $30.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.08 / $9.55 / $9.55
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 / $15.38
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $10.95 / $11.50
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.50 / $88.50 / $88.50
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.26 / $8.26 / $8.26
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.22 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $6.70 / $13.10
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.77 / $8.77 / $9.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $6.71 / $13.10