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Arizona rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Facilitymedian $32 · 10th–90th $8–$1150%5%10th90th$32Professionalmedian $14 · 10th–90th $8–$210%10%20%10th90th$14$0.2$1.0$5.0$20.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $15.14 / $20.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $74.13 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.88 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $13.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $19.05 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.23 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $9.33 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.23 / $15.49