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Iowa rates for HCPCS A4375

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

Facilitymedian $20 · 10th–90th $11–$1120%10%20%10th90th$20Professionalmedian $16 · 10th–90th $11–$260%10%10th90th$16$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
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $20.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $26.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $27.54 / $34.67
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $19.95 / $23.99
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $26.92 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $14.45 / $39.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $27.54 / $30.90
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $39.81 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $10.00 / $16.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $12.02 / $21.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.38 / $21.38