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Oklahoma rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.22
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $1.28 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.03 / $2.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.98 / $1.48