go back

Idaho rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $3.27 / $3.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.37 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.15 / $1.66
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $1.74 / $3.27
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.41 / $2.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.41 / $4.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $2.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.98 / $1.88