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Michigan rates for HCPCS A4375

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

Facilitymedian $30 · 10th–90th $11–$1100%10%20%10th90th$30Professionalmedian $15 · 10th–90th $11–$240%10%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $20.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $72.44 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $25.12
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
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 / $15.14 / $16.98
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $45.71 / $51.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $19.50 / $30.90
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $16.60
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $16.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $9.33 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $11.22 / $17.38