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Arkansas rates for HCPCS A5054

Ostomy pouch, closed; for use on barrier with flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $2.02 / $2.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $1.60 / $1.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $3.19 / $3.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $2.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $3.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.51 / $1.88
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.84 / $1.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.12 / $1.51