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Wisconsin rates for HCPCS A5054

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

Facilitymedian $3 · 10th–90th $2$50%20%40%10th90th$3Professionalmedian $2 · 10th–90th $1$40%20%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $4.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $2.40 / $2.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $7.41 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $3.72 / $4.79
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.19 / $3.63
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $3.80 / $4.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $2.51 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.26 / $2.75
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $4.07 / $4.07
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $2.88 / $5.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $3.80 / $6.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $5.13 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $2.57 / $12.59
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.57
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $1.12 / $1.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.26 / $2.04