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Montana rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Facilitymedian $2 · 10th–90th $2–$30%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$30%20%40%10th90th$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $2.51 / $2.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $2.51 / $2.51
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.78 / $2.34 / $4.57
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $2.34 / $4.57
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.17 / $2.09 / $2.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $2.51 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $0.93 / $0.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $1.02 / $1.38