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South Carolina 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
$10.73 / $10.73 / $10.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.05 / $10.73 / $11.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.52 / $8.52 / $8.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $12.60 / $16.14
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 / $8.07 / $9.49
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.36 / $11.27 / $21.71
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.40 / $10.40 / $10.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.06 / $9.06 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.19 / $8.26