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Maine rates for HCPCS A5057

Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (one piece), each

Facilitymedian $8 · 10th–90th $4–$80%50%10th$8Professionalmedian $8 · 10th–90th $5–$120%10%20%10th90th$8$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
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.76 / $12.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $9.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $14.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.76 / $12.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $5.13 / $5.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $11.48 / $11.75