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Arkansas rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $1.95 / $1.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.95 / $1.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.06 / $3.06 / $3.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $2.08 / $2.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.41 / $2.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.36 / $1.37 / $1.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.36 / $1.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.09 / $1.46