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Oklahoma rates for HCPCS A4375

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

Facilitymedian $21 · 10th–90th $14$250%20%10th90th$21Professionalmedian $14 · 10th–90th $7$210%10%20%10th90th$14$5.0$10.0$20.0$50.0$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
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $19.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $20.89 / $20.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $16.98
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $16.98 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $11.48 / $29.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $10.72 / $14.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $10.23 / $14.45