go back

Mississippi 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
$11.16 / $11.16 / $11.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.79 / $9.75 / $11.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.92 / $10.92 / $12.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.40 / $10.40 / $10.40
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 / $9.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.37 / $12.19