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Utah rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Facilitymedian $1 · 10th–90th $1–$10%20%40%10th90th$1Professionalmedian $1 · 10th–90th $1–$30%20%40%10th90th$1$0.0$0.1$0.5$2.0$10.0

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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.15 / $1.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.78 / $2.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.69
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.40 / $2.45
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $2.45 / $2.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $0.93 / $1.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.02 / $1.58