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Michigan 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
$9.84 / $10.22 / $10.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.40 / $10.22 / $10.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.05 / $13.41 / $13.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.62 / $40.44 / $75.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.74 / $13.41 / $18.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.72 / $13.41 / $19.91
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.73 / $17.43 / $18.77
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 / $8.53 / $11.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.69 / $9.69 / $10.22
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.35 / $10.22 / $14.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.19 / $7.74 / $10.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.30 / $10.32