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Vermont rates for HCPCS A5057

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

Facilitymedian $8 · 10th–90th $5–$90%50%10th90th$8Professionalmedian $9 · 10th–90th $7–$120%20%10th90th$9$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
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $8.91 / $12.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $10.96
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 / $8.51
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $13.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $6.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $8.71 / $26.92