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Louisiana rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.19 / $1.47 / $1.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $1.47 / $1.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $3.09 / $4.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.48 / $1.48
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $2.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.96 / $1.63