go back

Georgia 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
$1.59 / $1.59 / $1.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.59 / $2.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.44 / $1.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $2.09 / $4.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $2.13 / $4.01
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.13 / $2.13
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 / $2.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $2.50 / $3.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $1.20 / $2.06