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Vermont 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
Professional
Modifier
Low / Median / High Price
$1.32 / $1.69 / $1.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
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 / $1.44 / $1.60
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.44 / $1.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $1.52 / $2.89