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Michigan 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
$3.38 / $3.38 / $3.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $3.38 / $3.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.72 / $13.39 / $24.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.22 / $4.44 / $5.99
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.84 / $2.84 / $2.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.49 / $3.49 / $3.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $2.67 / $3.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $3.69
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.08 / $3.21 / $3.42
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $3.38 / $4.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.41 / $3.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.04 / $3.18