go back

Washington 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
$4.75 / $10.78 / $11.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.61 / $4.75 / $11.39
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.35 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.96 / $7.41 / $41.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.04 / $5.04 / $5.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $4.28 / $5.93
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.79 / $8.72 / $15.43
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.79 / $9.16 / $15.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.79 / $6.44 / $7.08
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.53 / $8.19 / $8.40
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.53 / $8.40 / $9.24
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.35 / $13.60
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $7.95 / $12.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.67 / $7.14 / $9.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.29 / $3.56 / $6.79
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $3.03 / $4.03