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Oregon rates for HCPCS A5054

Ostomy pouch, closed; for use on barrier with flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $1.84 / $7.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $4.25 / $5.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $2.20 / $2.52
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $2.38 / $2.64
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $2.45 / $2.89
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.50 / $2.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.50 / $2.20 / $2.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $2.20 / $2.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.76 / $2.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.07 / $2.02