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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 July 2026.

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

$3.55

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $3.55 for this service. The price depends on where it is billed: about $3.47 from a physician practice, and about $4.07 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.47$2.57 to $4.47
FacilityA hospital or hospital-owned outpatient department$4.07$2.75 to $4.37

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $5Professionalmedian $3 · 10th to 90th $2 to $6
$1.0$2.0$5.0$10.0$20.0$50.0facility $4professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$2.75
Median
$2.75
Typical High
$2.75
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.40
Median
$2.57
Typical High
$5.13
Avera
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.98
Typical High
$4.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$4.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$5.62
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$4.07
Typical High
$7.08
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$2.40
Typical High
$18.62
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$4.17
Typical High
$4.17
Midlands
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$4.27
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$3.47
Typical High
$6.76
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$3.80
Typical High
$5.01
United
Setting
Facility
Modifier
Global
Typical Low
$1.48
Median
$1.78
Typical High
$2.69
United
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$2.51
Typical High
$4.47
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$3.09
Median
$3.09
Typical High
$3.09

Where South Dakota sits

The same service costs 2.1 times more in Hawaii than in Colorado. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $3.55 · 5th of 51
HI $3.89CO $1.82

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.