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Indiana rates for HCPCS A5063

Ostomy Pouch Drainable; For Use On Barrier With Flange (2 Piece System) Each Ly. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.24 / $3.24 / $3.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.27 / $3.24
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $3.78 / $3.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $1.89 / $3.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $1.89 / $2.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.21 / $4.16 / $5.67
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.78 / $4.54 / $5.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $3.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.80 / $2.60