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California rates for HCPCS A5055

Stoma cap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.59 / $5.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.91 / $5.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.85 / $2.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.99 / $1.87
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $2.58 / $3.99
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $3.99 / $7.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $1.21 / $1.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.03 / $2.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $1.86 / $2.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.30 / $2.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.86 / $9.86 / $14.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $1.67 / $1.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.03 / $1.91
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $3.51 / $3.51
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $2.21 / $2.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.86