go back

Virginia rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.28 / $1.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.38
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.40 / $1.42
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $2.08 / $2.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $1.37 / $2.40
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.73 / $3.47
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.65 / $2.84
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $1.65 / $2.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.04 / $1.49