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Texas 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
$2.73 / $8.69 / $28.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.33 / $8.81 / $11.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.89 / $8.52 / $8.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.03 / $16.52 / $37.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.39 / $6.39 / $7.17
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $10.73 / $16.73
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.41 / $187.06 / $187.06
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 / $8.53
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.78 / $66.78 / $100.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.36 / $11.51 / $13.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $12.07 / $13.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.26 / $10.06 / $13.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $6.86 / $11.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $6.19 / $8.77
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $6.76 / $13.41