go back

Maine 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
Professional
Modifier
Low / Median / High Price
$5.86 / $7.70 / $7.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $6.58 / $6.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $9.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $10.95 / $10.95
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.22 / $7.70 / $7.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.70 / $15.40