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Washington rates for HCPCS A5054

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

Facilitymedian $3 · 10th–90th $2$50%20%10th90th$3Professionalmedian $2 · 10th–90th $1$40%20%40%10th90th$2$0.0$0.1$0.5$2.0$10.0$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
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.39
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $2.19
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.58 / $1.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.58
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $3.55 / $5.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $3.63 / $5.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.95 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.45 / $2.51
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.51
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.19 / $4.07
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $2.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.19 / $2.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.98 / $1.07 / $1.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.07 / $2.04
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $2.19 / $3.80