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Tennessee 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
$1.95 / $1.95 / $2.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.33 / $3.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.17 / $2.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $3.40 / $3.40
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.67 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.82 / $18.82 / $28.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.76 / $2.29