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Maine 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
Professional
Modifier
Low / Median / High Price
$1.04 / $2.17 / $2.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $1.89 / $1.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $1.93 / $2.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.09
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.16 / $2.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.88 / $4.34