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Ostomy Pouch, Closed, Barrier with Flange

Hawaii rates for HCPCS A5054

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

Rates data updated July 2026.

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

$2.57

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $2.57 for this service. Most negotiated rates run $1.41 to $2.57.

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 $1 · 10th to 90th $1 to $2Professionalmedian $3 · 10th to 90th $1 to $3
$1.0$2.0$5.0facility $1professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.41
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.51
Median
$1.58
Typical High
$2.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$2.34
Typical High
$3.16
HMSA
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.69
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.57
Typical High
$3.55
United
Setting
Facility
Modifier
Global
Typical Low
$0.81
Median
$0.85
Typical High
$0.98
United
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.78
Typical High
$3.16

Where Hawaii sits

The same service costs 2.0 times more in Wisconsin than in Colorado. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Hawaii $2.57 · 2nd of 51
WI $2.57CO $1.26

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.