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Michigan rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $1.58 / $1.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.58 / $1.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $6.33 / $11.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $2.08 / $2.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.66 / $1.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.47 / $2.27
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.50 / $1.58 / $3.43
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.58 / $2.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $1.11 / $1.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $0.97 / $1.49