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Washington rates for HCPCS A5126

Adhesive Or Non-Adhesive; Disk Or Foam Pad (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $2.04 / $2.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.90 / $2.11
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.40 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.43 / $9.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.10 / $1.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $0.94 / $1.35
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.27 / $1.65 / $3.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.65 / $3.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.24 / $1.36
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.52 / $1.83
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $1.60 / $1.83
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.40 / $2.59
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.49 / $2.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.36 / $1.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.85 / $1.48
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.78