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West Virginia rates for HCPCS A4375

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

Facilitymedian $13 · 10th–90th $13–$390%50%90th$13Professionalmedian $14 · 10th–90th $13–$200%20%10th90th$14$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.13 / $19.95
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $32.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $38.90 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.49 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $9.33 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $13.80 / $20.42