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Iowa rates for HCPCS A5063

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.41 / $2.41 / $2.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $2.40 / $3.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $4.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $4.16 / $5.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $4.16 / $4.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.58 / $4.41 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.91 / $5.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.15 / $4.16 / $4.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $4.48 / $7.94
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.57 / $472.57 / $472.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.88 / $4.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.40 / $3.40 / $3.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $3.40 / $3.40