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New Jersey rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.19 / $1.19 / $1.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $1.19 / $1.79
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 / $1.41
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.10 / $2.11 / $3.10
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.61 / $1.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.21 / $1.90