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Illinois rates for HCPCS A4376

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

Facilitymedian $68 · 10th–90th $37–$3800%20%10th90th$68Professionalmedian $43 · 10th–90th $31–$680%20%10th90th$43$0.5$2.0$10.0$50.0$200.0$1.0K

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
$37.15 / $37.15 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $40.74 / $67.61
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $173.78 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $72.44
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $83.18 / $107.15
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $25.70 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $33.11 / $53.70