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California rates for HCPCS A5061

Ostomy pouch, drainable; with barrier attached, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.45 / $14.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $2.16 / $14.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.94 / $4.94 / $4.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.72 / $2.06 / $5.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.38 / $2.46 / $4.59
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.19 / $6.75 / $10.42
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $10.59 / $18.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.87 / $2.97 / $3.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.52 / $3.14
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.94 / $5.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.96 / $3.46 / $7.66
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
$24.60 / $24.60 / $37.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $4.36 / $5.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.97 / $4.46
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.30 / $9.30 / $9.30
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $5.78 / $7.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $2.09 / $4.97