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Louisiana rates for HCPCS A5053

Ostomy Pouch Closed; For Use On Faceplate Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.39 / $1.71 / $1.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.71 / $1.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $3.59 / $5.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.71 / $1.71
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.15 / $1.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.12 / $1.59