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Arizona rates for HCPCS A5063

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.27 / $3.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $3.27 / $5.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $3.02 / $4.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $2.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $2.70 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.34 / $1.60 / $2.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.60 / $2.41