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North Carolina rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $1.79 / $1.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.79 / $1.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $2.73 / $3.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $1.54 / $1.69
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 / $1.36 / $1.80
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $1.79 / $2.44
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.37
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.90 / $2.90 / $4.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $1.01 / $1.56
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.70 / $14.70 / $17.18