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Connecticut 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
$1.62 / $1.62 / $1.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.62 / $1.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.60
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.22 / $1.63 / $1.63
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.76 / $2.31
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.21 / $1.43