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Ostomy Pouch, Closed, for Use on Faceplate

Utah rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Rates data updated October 2026.

How much does Ostomy Pouch, Closed, for Use on Faceplate cost?

$1.15

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $1.15 for this service. The price depends on where it is billed: about $1.15 from a physician practice, and about $0.68 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.15$1.00 to $1.74
FacilityA hospital or hospital-owned outpatient department$0.68$0.68 to $1.38

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $1 to $2
$1$2facility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.68
Median
$0.68
Typical High
$0.68
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.68
Median
$0.68
Typical High
$0.76
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.10
Median
$0.10
Typical High
$0.11
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.07
Median
$0.07
Typical High
$0.08
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$1.48
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.00
Median
$1.15
Typical High
$1.35
Molina
Setting
Professional
Modifier
None
Typical Low
$1.45
Median
$2.00
Typical High
$2.40
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
Select Health
Setting
Facility
Modifier
None
Typical Low
$2.45
Median
$2.45
Typical High
$2.45
Select Health
Setting
Professional
Modifier
None
Typical Low
$1.23
Median
$2.45
Typical High
$2.45
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$1.58
Median
$2.04
Typical High
$2.95
United
Setting
Professional
Modifier
None
Typical Low
$0.79
Median
$1.02
Typical High
$2.00

Where Utah sits

The same service costs 2.7 times more in Hawaii than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 46th of 51

$1.15

HI $3.09CT $1.15

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.