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Missouri 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
$1.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.32 / $2.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $1.55 / $2.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $2.14 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $1.26 / $12.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.98 / $1.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $1.20 / $1.78