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Missouri rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.10 / $2.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.26 / $2.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $1.78 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.05 / $14.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.81 / $1.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.00 / $1.48