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South Dakota rates for HCPCS A5052

Ostomy pouch, closed; without barrier attached (one piece), each

Facilitymedian $1 · 10th–90th $1–$30%20%40%10th90th$1Professionalmedian $1 · 10th–90th $1–$30%20%40%90th$1$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.29 / $4.47
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.32 / $14.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $2.29 / $2.29
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.34 / $2.34 / $2.34
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $3.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $2.09 / $2.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $1.38 / $2.45
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $1.86