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Illinois 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
$4.71 / $4.71 / $4.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.92 / $4.71 / $8.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.53 / $21.20 / $73.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $6.30 / $6.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.04 / $5.04 / $9.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.04 / $9.75
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.40 / $12.15 / $17.07
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.92 / $10.92 / $10.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.99 / $11.42 / $12.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $4.19 / $7.42