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South Carolina 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
$6.71 / $6.71 / $6.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $6.71 / $7.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.05 / $8.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.59 / $5.04 / $5.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.04 / $5.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.21 / $7.09 / $13.18
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.67 / $5.67 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $3.78 / $5.05