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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
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $2.24 / $2.82
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $6.61 / $7.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $2.29 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $1.26 / $3.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.40 / $2.69
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $2.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $3.47 / $3.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.87 / $1.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $1.05 / $1.91
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.86 / $1.86