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New Hampshire rates for HCPCS A5054

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

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

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
$1.32 / $1.32 / $1.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $4.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.85 / $1.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.45 / $2.19
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $3.31