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Ostomy Pouch, Closed, Barrier with Flange

Pennsylvania 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?

$1.55

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1.55 for this service. The price depends on where it is billed: about $1.55 from a physician practice, and about $1.95 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.55$1.29 to $1.78
FacilityA hospital or hospital-owned outpatient department$1.95$1.23 to $7.94

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $13Professionalmedian $2 · 10th to 90th $1 to $3
$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0Kfacility $2professional $2

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.55
Typical High
$2.40
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.51
Median
$1.51
Typical High
$3.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.55
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$2.82
Typical High
$4.90
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.57
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.55
Typical High
$2.57
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$1.86
Typical High
$1.86
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.95
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.55
Typical High
$2.09
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$8.91
Typical High
$14.45
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.40
Typical High
$2.40
United
Setting
Facility
Modifier
Global
Typical Low
$0.85
Median
$1.12
Typical High
$1.58
United
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$1.26
Typical High
$2.63

Where Pennsylvania 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.

Pennsylvania $1.55 · 40th 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.