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Alaska rates for HCPCS A5052

Ostomy pouch, closed; without barrier attached (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $1.98 / $1.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.06
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $1.98 / $3.12
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.02
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.02 / $4.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $1.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.73 / $4.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.99