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Virginia rates for HCPCS A4375

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

Facilitymedian $19 · 10th–90th $14–$400%20%10th90th$19Professionalmedian $14 · 10th–90th $10–$220%20%10th90th$14$0.2$2.0$20.0$200.0$2.0K

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
$14.13 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $14.13 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $25.12
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.98
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $24.55 / $33.88
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $17.38 / $25.70
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $17.38 / $29.51
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $14.79 / $15.85
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $21.38 / $70.79
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $21.38 / $70.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $9.33 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $12.02 / $19.05