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Idaho rates for HCPCS A4375

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

Facilitymedian $22 · 10th–90th $8–$340%20%10th90th$22Professionalmedian $17 · 10th–90th $9–$270%10%10th90th$17$0.5$1.0$2.0$5.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $15.14 / $32.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $22.39 / $38.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $26.92 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $15.85
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $22.39 / $32.36
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $23.44 / $25.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $25.70
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $24.55 / $24.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $9.33 / $12.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $10.23 / $13.80