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Massachusetts rates for HCPCS A5073

Ostomy Pouch Urinary; For Use On Barrier With Flange (2 Piece) Each (Updated 01-01-2003) Cm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $1.94 / $1.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.94 / $1.94 / $3.33
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $12.66 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $2.99 / $4.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.90 / $2.90 / $8.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $3.16 / $3.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $3.00 / $3.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $5.25
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
$3.62 / $3.62 / $3.80
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $2.80 / $2.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.01 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $2.21 / $4.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $2.21 / $4.34