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South Carolina 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
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $3.02 / $3.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $1.72 / $2.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $4.00 / $5.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $2.27 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.27 / $2.67
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $3.20 / $5.94
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.55 / $2.55 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.70 / $2.27