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Ostomy Pouch, Drainable, Barrier with Flange

Montana 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?

$3.98

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $3.98 for this service. The price depends on where it is billed: about $3.98 from a physician practice, and about $4.17 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.98$2.95 to $3.98
FacilityA hospital or hospital-owned outpatient department$4.17$3.89 to $219

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $224Professionalmedian $4 · 10th to 90th $2 to $79
$2$5$10$20$50$100$200facility $4professional $4

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
Professional
Modifier
None
Typical Low
$1.05
Median
$3.02
Typical High
$3.31
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$3.72
Median
$3.72
Typical High
$3.72
Cigna
Setting
Facility
Modifier
None
Typical Low
$3.55
Median
$3.98
Typical High
$3.98
Cigna
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$3.98
Typical High
$3.98
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$2.88
Median
$4.79
Typical High
$223.87
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$3.89
Median
$4.27
Typical High
$234.42
Providence
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$3.98
Typical High
$3.98
Providence
Setting
Professional
Modifier
None
Typical Low
$2.95
Median
$3.98
Typical High
$79.43
United
Setting
Professional
Modifier
None
Typical Low
$1.51
Median
$1.58
Typical High
$2.69

Where Montana 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.

Montana· 2nd of 51

$3.98

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.