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Montana rates for HCPCS A5055

Stoma cap

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $5.38 / $5.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $1.90 / $1.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $2.04 / $2.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $1.95 / $2.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $1.57 / $2.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.85 / $1.00