go back

Massachusetts rates for HCPCS A5071

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.67 / $3.67 / $3.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.67 / $6.36
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.67 / $17.05 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $5.64 / $8.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.32 / $4.32 / $12.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.30 / $5.96 / $5.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $5.04 / $5.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.04 / $9.75
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
$6.85 / $6.85 / $7.19
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.80 / $4.80 / $4.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.05 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $4.19 / $8.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $4.19 / $8.19