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Massachusetts rates for HCPCS A4375

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

Facilitymedian $16 · 10th–90th $10$1150%20%40%10th90th$16Professionalmedian $18 · 10th–90th $10$230%20%40%10th90th$18$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$10.00
Median
$10.00
Typical High
$10.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$15.14
Typical High
$21.88
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$23.44
Typical High
$114.82
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$18.62
Typical High
$26.92
BCBS
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$50.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$15.85
Typical High
$16.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$13.49
Typical High
$16.60
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$31.62
Health New England
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$11.48
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$23.44
Typical High
$114.82
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$18.62
Typical High
$26.92
United
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$9.77
Typical High
$13.80
United
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$14.79
Typical High
$20.89