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Massachusetts rates for HCPCS A5061

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $2.16 / $3.69
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.32 / $10.02 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $3.32 / $4.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $9.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.51 / $3.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $2.97 / $3.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.97 / $5.63
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.22
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.02 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.46 / $4.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $2.46 / $4.82