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Vermont rates for HCPCS A5055

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.36 / $1.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.03 / $1.03
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.03 / $1.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $1.22 / $2.31