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Minnesota rates for HCPCS A4375

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

Facilitymedian $56 · 10th–90th $15–$1740%10%10th90th$56Professionalmedian $24 · 10th–90th $13–$280%50%10th90th$24$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.14 / $19.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $28.18 / $41.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $30.20 / $35.48
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $173.78
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $29.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $23.99 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $10.23 / $28.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.16 / $9.33 / $9.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $12.02 / $33.11