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Minnesota 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
$1.53 / $1.53 / $1.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.53 / $1.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2.58 / $3.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.34 / $2.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $7.24 / $20.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.78 / $3.33
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.30 / $6.88 / $15.84
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $2.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.69 / $2.41 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.03 / $2.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.03 / $2.43