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Louisiana 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
$1.44 / $1.78 / $1.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.78 / $1.99
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $3.74 / $5.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.78 / $1.78
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.00 / $264.00 / $264.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.47 / $1.51 / $1.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.15 / $1.85