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Ohio rates for HCPCS A4375

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

Facilitymedian $16 · 10th–90th $9–$250%20%10th90th$16Professionalmedian $14 · 10th–90th $10–$220%10%20%10th90th$14$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
$15.14 / $19.95 / $25.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $14.45 / $31.62
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $20.42 / $28.84
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $21.38 / $32.36
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 / $13.49 / $13.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $13.49 / $13.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $17.78 / $25.70
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $27.54 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.77 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $11.22 / $16.22