go back

Washington rates for HCPCS A5072

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $6.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $3.02 / $5.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.88 / $2.88 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.45 / $2.88
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $6.61 / $11.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.92 / $11.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $3.80 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $4.37 / $4.90
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.47 / $4.90
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $4.37 / $7.94
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.07 / $5.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.27 / $5.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $1.91 / $2.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $2.09 / $3.98
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $4.27 / $7.59