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Washington 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
$7.60 / $17.25 / $18.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.71 / $8.56 / $18.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.72 / $13.41 / $13.41
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.40 / $75.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.39 / $11.85 / $66.78
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.06 / $13.79 / $23.64
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $14.17 / $24.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.26 / $10.29 / $11.31
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.04 / $13.10 / $13.41
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.07 / $13.41 / $14.75
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.14 / $11.75 / $21.72
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.14 / $12.71 / $19.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.66 / $11.40 / $14.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.26 / $5.69 / $10.85
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $12.61 / $12.61