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Oregon 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 $11$130%50%10th90th$13Professionalmedian $8 · 10th–90th $4$150%10%10th90th$8$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $10.00
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 / $6.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $25.12 / $28.84
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $10.23 / $14.45
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $10.96 / $15.14
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $13.18 / $13.49
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $13.49 / $14.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $12.88 / $16.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $12.88 / $79.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $15.14 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $5.13 / $6.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.75 / $10.96