go back

Oklahoma 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
$1.50 / $1.50 / $1.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.47 / $1.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $2.20 / $2.20
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 / $1.50 / $1.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $1.58 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.20 / $2.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.12 / $1.52