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Kansas 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
$2.77 / $2.77 / $2.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.34 / $2.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $2.23 / $2.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.25 / $2.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.51 / $3.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $2.16 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.25 / $3.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.15 / $1.79