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Utah rates for HCPCS A5063

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

Facilitymedian $1 · 10th–90th $1–$20%50%90th$1Professionalmedian $2 · 10th–90th $1–$170%10%20%10th90th$2$0.0$0.1$0.5$2.0$10.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $16.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $2.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $2.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $2.75 / $4.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $2.69 / $4.27
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.80 / $3.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $3.89 / $4.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.45 / $1.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.58 / $2.88