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Idaho rates for HCPCS A5054

Ostomy Pouch Closed; For Use On Barrier With Flange (2 Piece) Each (Updated 01-01-2003) M: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $3.41 / $3.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $1.74 / $3.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.38 / $2.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.50 / $4.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.76 / $2.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.01 / $1.79