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New York 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
$5.84 / $6.71 / $12.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $8.35 / $12.69
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.72 / $8.72 / $8.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $6.56 / $19.61
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.40 / $11.18 / $11.18
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.18 / $11.18 / $11.18
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
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.41 / $30.17 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.91 / $10.42 / $24.54
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.42 / $10.42 / $10.42
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.34 / $8.86 / $11.18
Fidelis
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.98 / $6.98 / $8.75
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.89 / $10.89 / $10.89
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.22 / $19.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.70 / $11.57
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.34 / $8.34 / $8.34
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.34 / $8.34 / $10.42