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South Dakota rates for HCPCS A5054

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

Facilitymedian $2 · 10th–90th $1–$30%20%40%10th90th$2Professionalmedian $2 · 10th–90th $1–$40%20%40%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. Small sample — interpret with caution. 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 / $3.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.72
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.70 / $2.69 / $4.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.58 / $12.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.75 / $2.75
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $2.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $4.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.51 / $3.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.66 / $2.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.24