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Wisconsin 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 $13–$250%20%40%10th90th$14Professionalmedian $10 · 10th–90th $7–$200%10%20%10th90th$10$5.0$10.0$20.0$50.0$100.0

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 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $22.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $15.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $41.69 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $19.05 / $25.70
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $11.48 / $16.22
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $13.49 / $16.22
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $13.49 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $6.76 / $14.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $15.49 / $26.92
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $20.42 / $35.48
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $26.92 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $13.80 / $66.07
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $6.17 / $9.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.76 / $10.96