go back

Montana rates for HCPCS A5057

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

Facilitymedian $13 · 10th–90th $8–$160%20%10th90th$13Professionalmedian $11 · 10th–90th $5–$180%10%10th90th$11$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $8.91 / $18.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $14.13 / $14.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $14.13 / $14.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $13.18 / $25.70
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $13.18 / $25.70
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $12.59 / $15.85
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $5.13 / $5.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.75 / $8.32