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Illinois 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
$2.00 / $2.00 / $4.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $4.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.90 / $9.55 / $38.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $3.31 / $3.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $2.69 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $5.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.46 / $8.71
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $5.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.74 / $4.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $2.19 / $3.47