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New Jersey 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
$1.22 / $1.22 / $1.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $1.22 / $2.08
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 / $1.28 / $1.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.22 / $2.76
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.67 / $1.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.25 / $2.31