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Nebraska rates for HCPCS A4375

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

Facilitymedian $24 · 10th–90th $9–$1120%10%10th90th$24Professionalmedian $19 · 10th–90th $9–$650%10%10th90th$19$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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $19.05 / $104.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $23.44 / $23.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $26.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $26.30 / $40.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $33.88 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $12.02 / $23.99
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $64.57
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $60.26 / $64.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $10.96 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $12.02 / $18.62