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Tennessee rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Facilitymedian $2 · 10th–90th $1–$850%20%40%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.20 / $1.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $1.58 / $1.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.15 / $1.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $17.38 / $17.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.00 / $1.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $0.98 / $1.38