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Ostomy Pouch, Drainable, Barrier with Flange

South Dakota 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?

$3.16

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $3.16 for this service. The price depends on where it is billed: about $3.16 from a physician practice, and about $4.37 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.16$2.51 to $4.17
FacilityA hospital or hospital-owned outpatient department$4.37$2.75 to $4.37

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $7Professionalmedian $3 · 10th to 90th $2 to $5
$2$5$10$20$50facility $4professional $3

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2.75
Median
$2.75
Typical High
$2.75
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.57
Median
$2.57
Typical High
$2.82
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$4.27
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.47
Typical High
$5.62
Medica
Setting
Facility
Modifier
None
Typical Low
$2.57
Median
$4.37
Typical High
$7.08
Medica
Setting
Professional
Modifier
None
Typical Low
$1.51
Median
$2.14
Typical High
$18.62
Midlands
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.17
Typical High
$4.27
Midlands
Setting
Professional
Modifier
None
Typical Low
$3.47
Median
$3.47
Typical High
$6.76
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$3.80
Typical High
$4.37
United
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.78
Typical High
$2.82
Wellmark
Setting
Professional
Modifier
None
Typical Low
$3.09
Median
$3.09
Typical High
$3.09

Where South Dakota 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.

South Dakota· 15th of 51

$3.16

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.