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Vermont rates for HCPCS A5053

Ostomy Pouch Closed; For Use On Faceplate Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.59 / $1.59
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 / $1.44
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.41
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.36 / $1.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $1.44 / $2.72