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Indiana rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.53 / $2.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.14 / $1.14 / $2.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.77 / $2.56 / $3.37
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.65 / $3.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.15 / $2.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.13 / $1.69