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Montana rates for HCPCS A5073

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.81 / $12.80 / $12.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.69 / $3.69 / $3.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $3.96 / $3.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $3.96 / $3.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $3.77 / $3.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.84 / $3.25 / $4.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.88 / $3.14