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California rates for HCPCS A4375

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

Facilitymedian $11 · 10th–90th $9$330%20%10th90th$11Professionalmedian $15 · 10th–90th $8$830%10%20%10th90th$15$0.2$1.0$5.0$20.0$100.0$500.0

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
$6.03 / $7.08 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $15.14 / $91.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $11.48 / $28.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $32.36
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $33.88 / $51.29
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $44.67 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $15.85
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $26.92 / $33.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $21.88 / $40.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $181.97
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $22.91 / $31.62
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $19.95
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $21.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.70 / $9.33 / $10.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $10.72 / $25.70