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Massachusetts rates for HCPCS A5072

Ostomy Pouch Urinary; Without Barrier Attached (1piece) Each (Updated 01-01-2003) 30)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.16 / $3.32
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $10.33 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $3.32 / $4.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.35 / $3.35 / $9.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $3.51 / $3.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $2.86 / $3.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.43 / $3.66
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
$4.01 / $4.01 / $4.22
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.20
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.02 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.46 / $4.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $2.46 / $4.82