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Montana rates for HCPCS A5054

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

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

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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.26 / $3.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.63 / $2.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $2.63 / $2.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $2.45 / $4.79
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $2.45 / $4.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $2.09 / $3.02
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $2.63 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $0.98 / $0.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.95 / $1.07 / $1.45