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Michigan rates for HCPCS A5072

Ostomy pouch, urinary; without barrier attached (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.76 / $3.76 / $3.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.72 / $3.76 / $3.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.48 / $15.03 / $27.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.69 / $4.94 / $6.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.21 / $3.21 / $3.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.36 / $3.36 / $3.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $2.86 / $2.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.43 / $2.86 / $4.09
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.39 / $2.66 / $3.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.96 / $3.76 / $5.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $3.00 / $4.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $2.31 / $3.52