go back

Washington 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 $8$250%20%10th90th$13Professionalmedian $9 · 10th–90th $5$200%10%10th90th$9$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
$7.08 / $7.08 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.94 / $18.20
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $11.75
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.51 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $8.32
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $16.60 / $27.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $17.38 / $28.18
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $11.22 / $60.26
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
$12.02 / $13.49 / $13.49
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $11.75 / $21.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $13.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $11.75 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.13 / $5.89 / $8.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.75 / $10.96
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $11.75 / $20.42