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Minnesota rates for HCPCS A5056

Ostomy pouch, drainable, with extended wear barrier attached, with filter, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $4.17 / $4.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $6.97 / $9.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.22 / $6.33 / $6.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.93 / $19.66 / $54.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.95 / $9.52
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.67 / $18.86 / $42.99
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.50 / $7.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $6.53 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $3.10 / $6.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $2.77 / $6.56