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Missouri 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
$1.62 / $2.64 / $3.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $2.12 / $4.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $1.89 / $3.06
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 / $1.93 / $2.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.76 / $3.31 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.88 / $3.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.88 / $2.84