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South Carolina 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
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $4.57 / $5.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.69 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $5.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.82 / $3.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.51 / $3.98 / $7.24
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.74 / $2.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.14 / $2.88