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South Carolina 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
$3.55 / $3.55 / $3.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $3.55 / $3.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $3.78 / $5.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.67 / $2.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $3.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.23 / $4.00 / $6.98
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.00 / $2.67