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Illinois rates for HCPCS A4375

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

Facilitymedian $25 · 10th–90th $13$1350%20%10th90th$25Professionalmedian $15 · 10th–90th $10$250%20%10th90th$15$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
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$24.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$14.79
Typical High
$24.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$61.66
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$17.78
Typical High
$17.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$15.85
Typical High
$26.92
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$13.49
Typical High
$16.98
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$21.88
Typical High
$33.88
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$11.48
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$9.33
Typical High
$24.55
United
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.02
Typical High
$19.50