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Texas rates for HCPCS A5057

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

Facilitymedian $14 · 10th–90th $8$380%10%10th90th$14Professionalmedian $8 · 10th–90th $6$110%20%10th90th$8$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$2.75 / $7.94 / $13.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $8.51 / $9.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $15.49 / $37.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $7.24
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $10.96 / $16.60
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $186.21 / $186.21
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 / $8.13
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $13.49 / $19.95
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $7.94 / $12.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $13.49 / $19.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $8.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $5.75 / $8.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.17 / $8.71
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $13.80 / $13.80