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Minnesota 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $2.45 / $3.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.09 / $2.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.27 / $7.41 / $18.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.57 / $2.88
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $7.24 / $14.13
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $2.09 / $4.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.87 / $2.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.79 / $0.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.98 / $2.45