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Washington, DC rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.63 / $1.63 / $1.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $1.63 / $1.63
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $1.65 / $1.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $0.98 / $1.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.21 / $1.71