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California rates for HCPCS A5071

Ostomy Pouch Urinary; With Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $2.47 / $24.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.47 / $3.79 / $24.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.90 / $3.49 / $9.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.03 / $4.15 / $7.81
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.84 / $11.48 / $17.73
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.54 / $18.01 / $31.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.77 / $5.04 / $6.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $4.28 / $5.34
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.72 / $8.40 / $10.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.88 / $13.02
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
$41.83 / $41.83 / $63.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $7.42 / $8.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.04 / $7.99
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.84 / $15.84 / $15.84
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.72 / $9.83 / $12.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $3.56 / $8.47