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Indiana rates for HCPCS A4375

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

Facilitymedian $20 · 10th–90th $9–$230%20%10th90th$20Professionalmedian $14 · 10th–90th $10–$200%10%20%10th90th$14$10.0$20.0$50.0$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
$20.42 / $20.42 / $20.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.14 / $20.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $23.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $23.99
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $30.90 / $36.31
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 / $16.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.33 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $11.48 / $17.38