go back

New York rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.01 / $1.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $1.01 / $1.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.37 / $3.26
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.61 / $1.73 / $1.73
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
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 / $1.06 / $1.47
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $4.68 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.91 / $3.74
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $1.58 / $1.58
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.73
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.33
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.11 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.04 / $1.79
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.71
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.58