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New York rates for HCPCS A4375

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

Facilitymedian $18 · 10th–90th $10$410%20%40%10th90th$18Professionalmedian $13 · 10th–90th $10$320%20%10th90th$13$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $19.50 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.14 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.88 / $33.11
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $19.95 / $19.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $19.95
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $40.74 / $93.33
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $25.70 / $46.77
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $19.05
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $18.20
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $23.44 / $23.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $10.23 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $15.85 / $41.69
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $19.05
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $18.20