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Ostomy Pouch, Closed, Barrier with Flange

Washington, DC rates for HCPCS A5054

Ostomy pouch, closed; for use on barrier with flange (two piece), each

Rates data updated October 2026.

How much does Ostomy Pouch, Closed, Barrier with Flange cost?

$1.70

Typical negotiated rate. In Washington, DC, October 2026.

Insurers have agreed to pay about $1.70 for this service. Most negotiated rates run $1.35 to $1.78.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $2Professionalmedian $2 · 10th to 90th $1 to $2
$1$2$5facility $2professional $2

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
$1.70
Median
$1.70
Typical High
$1.70
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.23
Median
$1.70
Typical High
$2.19
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.18
Median
$0.26
Typical High
$0.27
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.12
Median
$0.17
Typical High
$0.18
CareFirst
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$1.70
Typical High
$1.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.62
Median
$1.62
Typical High
$1.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.29
Median
$1.29
Typical High
$1.51
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$2.04
Median
$2.19
Typical High
$5.01
United
Setting
Professional
Modifier
None
Typical Low
$0.83
Median
$1.35
Typical High
$2.57

Where Washington, DC sits

The same service costs 2.1 times more in Idaho 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.

Washington, DC· 23rd of 51

$1.70

ID $2.69CT $1.29

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.