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Ohio 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 / $1.74 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.23 / $2.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $2.09 / $2.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.86 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.26
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $4.79
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.48 / $2.24
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.34 / $4.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.74 / $0.85 / $1.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.98 / $1.32