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South Carolina rates for HCPCS A4375

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

Facilitymedian $19 · 10th–90th $10–$340%20%10th90th$19Professionalmedian $15 · 10th–90th $10–$210%10%10th90th$15$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
$10.00 / $15.14 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $24.55 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $16.60
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.49
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $22.39 / $38.90
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $8.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.33 / $15.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $11.48 / $15.49