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South Carolina rates for HCPCS A5057

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

Facilitymedian $10 · 10th–90th $6–$180%20%10th90th$10Professionalmedian $8 · 10th–90th $5–$110%20%10th90th$8$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
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $13.80 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $15.49
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $11.75 / $20.42
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $8.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $5.25 / $8.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.46 / $9.33