go back

Maine rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $1.26 / $1.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.14 / $1.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.15 / $1.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.26 / $1.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $1.11 / $2.52