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Hawaii rates for HCPCS A4375

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

Facilitymedian $9 · 10th–90th $8–$200%20%10th90th$9Professionalmedian $17 · 10th–90th $10–$280%20%10th90th$17$10.0$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $12.88 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $20.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $16.98 / $32.36
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $27.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $26.30 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $9.33 / $9.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $14.45 / $28.18