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California rates for HCPCS A5073

Ostomy pouch, urinary; for use on barrier with flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.19 / $1.31 / $12.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.86 / $12.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.83 / $3.83 / $3.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.53 / $1.85 / $4.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.18 / $4.13
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.69 / $6.09 / $9.41
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $9.52 / $16.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $2.67 / $3.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.27 / $3.30
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $4.44 / $5.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.11 / $6.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.98 / $21.98 / $32.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.22 / $3.93 / $4.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $4.17
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $8.36 / $8.36
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $5.20 / $6.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.88 / $4.29