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Arkansas rates for HCPCS A5063

Ostomy pouch, drainable; for use on barrier with flange (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $3.04 / $3.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.80 / $4.80 / $4.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.78 / $3.78 / $4.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $3.78 / $4.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.84
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $2.76 / $2.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.70 / $2.27