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Washington rates for HCPCS A5121

Skin barrier; solid, 6 x 6 or equivalent, each

Facilitymedian $10 · 10th–90th $9–$200%20%10th90th$10Professionalmedian $6 · 10th–90th $4–$150%10%20%10th90th$6$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $12.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $11.75
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $6.31 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $6.31
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $23.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $14.45 / $22.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $7.94 / $60.26
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $10.23 / $10.47
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $10.47 / $10.47
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $9.12 / $16.98
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $10.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $9.12 / $11.75
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $4.47 / $6.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $4.47 / $8.51
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $9.12 / $15.85