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Arkansas rates for HCPCS A5055

Stoma Cap (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.62 / $1.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.84 / $1.84 / $2.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.84 / $1.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.21 / $1.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.03 / $1.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.91 / $1.21