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Ostomy Pouch, Drainable, Barrier with Flange

Michigan rates for HCPCS A5063

Ostomy pouch, drainable; for use on barrier with flange (two-piece system), each

Rates data updated October 2026.

How much does Ostomy Pouch, Drainable, Barrier with Flange cost?

$3.24

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $3.24 for this service. The price depends on where it is billed: about $3.16 from a physician practice, and about $6.03 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.16$2.69 to $3.80
FacilityA hospital or hospital-owned outpatient department$6.03$2.40 to $11.22

How much rates vary

Facilitymedian $6 · 10th to 90th $2 to $17Professionalmedian $3 · 10th to 90th $2 to $4
$1$2$5$10$20facility $6professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3.39
Median
$3.39
Typical High
$3.55
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$3.55
Typical High
$3.55
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.51
Median
$0.52
Typical High
$0.52
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.34
Median
$0.36
Typical High
$0.36
Ambetter
Setting
Professional
Modifier
None
Typical Low
$2.88
Median
$2.88
Typical High
$2.88
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$4.57
Median
$11.22
Typical High
$20.89
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$3.63
Median
$3.80
Typical High
$3.80
CareSource
Setting
Facility
Modifier
None
Typical Low
$2.45
Median
$2.45
Typical High
$2.45
CareSource
Setting
Professional
Modifier
None
Typical Low
$3.80
Median
$5.25
Typical High
$5.37
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$2.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$2.40
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$2.40
Median
$2.95
Typical High
$8.13
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$2.34
Median
$2.88
Typical High
$3.89
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.43
Median
$0.43
Typical High
$0.43
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.28
Median
$0.28
Typical High
$0.28
Priority Health
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$2.40
Priority Health
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$2.69
United
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.78
Typical High
$2.51
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$3.80
Median
$3.80
Typical High
$3.80

Where Michigan sits

The same service costs 2.1 times more in Idaho than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 14th of 51

$3.24

ID $4.07NJ $1.95

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.