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New Jersey 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
$1.85 / $1.85 / $1.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.85 / $3.13
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 / $2.67
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.13 / $4.16
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $2.50 / $2.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.88 / $3.46