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California rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $0.91 / $1.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.90 / $2.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $3.26
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.85 / $4.40
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $4.46 / $7.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $2.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.08 / $2.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.46 / $3.22
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.70 / $15.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $1.86 / $2.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.98
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.92 / $3.92 / $3.92
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.44 / $3.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.88 / $2.04