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Ostomy Pouch, Drainable, Barrier with Flange

Nebraska 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?

$2.88

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $2.88 for this service. The price depends on where it is billed: about $2.88 from a physician practice, and about $4.27 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$2.88$1.86 to $4.17
FacilityA hospital or hospital-owned outpatient department$4.27$3.09 to $5.89

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $79Professionalmedian $3 · 10th to 90th $1 to $5
$1$2$5$10$20$50facility $4professional $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
$3.80
Median
$3.80
Typical High
$3.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.05
Median
$3.80
Typical High
$5.01
Ambetter
Setting
Professional
Modifier
None
Typical Low
$2.88
Median
$2.88
Typical High
$2.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$4.27
Typical High
$4.27
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.27
Typical High
$7.94
Medica
Setting
Facility
Modifier
None
Typical Low
$3.09
Median
$3.80
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$1.29
Median
$1.86
Typical High
$3.72
Midlands
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.27
Typical High
$7.94
Midlands
Setting
Professional
Modifier
None
Typical Low
$5.25
Median
$7.94
Typical High
$10.47
United
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.78
Typical High
$2.40
2 more rates 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
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.37
Median
$0.56
Typical High
$0.76
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.25
Median
$0.38
Typical High
$0.50

Where Nebraska 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.

Nebraska· 17th of 51

$2.88

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.