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Wisconsin rates for HCPCS A5053

Ostomy pouch, closed; for use on faceplate, each

Facilitymedian $2 · 10th–90th $2$40%20%40%10th90th$2Professionalmedian $1 · 10th–90th $1$30%20%40%10th90th$1$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $3.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $2.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $7.41 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.69 / $3.98
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $2.00 / $2.95
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $2.51 / $3.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $2.04 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.95 / $1.20 / $2.45
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.31 / $3.31
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $2.34 / $4.07
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $3.24 / $6.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $4.17 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.35 / $14.79
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $2.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $2.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.10 / $1.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.02 / $1.78