go back

Vermont rates for HCPCS A5052

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.40 / $1.40
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 / $1.44
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.27 / $2.40