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Indiana 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
Facility
Modifier
Low / Median / High Price
$2.15 / $2.15 / $2.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.59 / $2.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $2.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $2.67 / $3.77
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.76 / $3.39
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 / $1.51 / $2.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.20 / $1.78