go back

Washington 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
$2.48 / $5.63 / $5.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.48 / $5.88
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.84 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $3.84 / $21.98
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 / $2.27 / $3.41
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $4.59 / $8.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $4.59 / $8.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.36 / $3.69
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $3.99 / $4.44
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.77 / $4.07 / $4.44
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.64 / $3.84 / $7.10
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $4.15 / $6.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.48 / $3.72 / $4.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.75 / $1.88 / $3.60
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.24 / $2.24