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Minnesota 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
$1.60 / $1.60 / $1.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.60 / $1.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2.68 / $3.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.43 / $2.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $7.24 / $20.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.09 / $3.81
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.30 / $6.95 / $15.84
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $3.00 / $3.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $2.50 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.18 / $2.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.18 / $4.58