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Massachusetts rates for HCPCS A5054

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

Facilitymedian $2 · 10th–90th $1–$790%20%10th90th$2Professionalmedian $2 · 10th–90th $1–$20%20%40%10th90th$2$1.0$10.0$100.0$1.0K$10.0K

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 / $2.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.57 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.91 / $2.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $4.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.51 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $3.47
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $3.31
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.57 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.91 / $2.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.02 / $1.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.55 / $2.19