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Indiana rates for HCPCS A5126

Adhesive or nonadhesive; disk or foam pad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.43 / $1.43 / $1.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.99 / $1.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $0.78 / $1.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.78 / $1.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.75 / $2.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.84 / $2.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.10 / $1.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.10 / $1.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.80 / $1.21