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Illinois rates for HCPCS A5052

Ostomy Pouch Closed; Without Barrier Attached (1 Piece) Each (Updated 01-01-2003) 0)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.17 / $1.17 / $1.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.97 / $1.17 / $2.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.18 / $5.61 / $18.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.56 / $1.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $2.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $2.39
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.08 / $6.57 / $8.59
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $2.83 / $3.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $1.04 / $1.78