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North Carolina 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
$3.31 / $3.31 / $3.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $3.31 / $3.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $2.27 / $3.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $5.03 / $5.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.84 / $3.12
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 / $4.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $3.31 / $4.50
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.80
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.50 / $7.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.79 / $2.73
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.82 / $18.82 / $28.35