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Alaska rates for HCPCS A5063

Ostomy pouch, drainable; for use on barrier with flange (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.34
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.04
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $5.67
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $3.31 / $3.69
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.99 / $3.69 / $7.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $1.04 / $3.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $3.04 / $4.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $1.88 / $3.61