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South Dakota rates for HCPCS A5057

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

Facilitymedian $9 · 10th–90th $8–$170%20%40%10th90th$9Professionalmedian $11 · 10th–90th $7–$190%20%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.94 / $18.20
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $14.13 / $14.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $19.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $14.45 / $25.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $8.71 / $66.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.79 / $14.79
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $23.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $13.49 / $17.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $8.91 / $15.85
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02