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Maine rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $1.19 / $1.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.19 / $1.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.04 / $2.38