go back

Oklahoma rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.24 / $1.24 / $1.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $1.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.24 / $1.82 / $1.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $2.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $1.30 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.99 / $2.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.88 / $1.27