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Vermont 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
$1.00 / $1.00 / $1.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
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
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.45 / $2.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $0.98 / $1.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $1.51 / $5.25