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Wisconsin rates for HCPCS A5051

Ostomy pouch, closed; with barrier attached (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $2.95 / $4.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.75 / $3.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $9.55 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $4.27 / $5.62
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $2.40 / $4.17
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $5.01 / $6.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $2.88 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.48 / $3.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $4.37 / $7.41
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $5.89 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $3.16 / $14.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.23 / $1.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.45 / $2.40