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Montana rates for HCPCS A5051

Ostomy Pouch Closed; With Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.47 / $2.47 / $2.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $3.02 / $3.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $3.02 / $3.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $2.88 / $3.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.27 / $3.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.22 / $2.04