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Iowa rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $1.32 / $1.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $2.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.25 / $2.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.08 / $6.47 / $7.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $2.67 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $1.04 / $2.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $2.46 / $4.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.04 / $2.72
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.87 / $1.87 / $1.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.87 / $1.87