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Montana rates for HCPCS A4376

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

Facilitymedian $65 · 10th–90th $41–$810%20%40%10th90th$65Professionalmedian $51 · 10th–90th $28–$890%10%10th90th$51$20.0$50.0$100.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $47.86 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $69.18 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $69.18 / $69.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $64.57 / $125.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $64.57 / $125.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $61.66 / $79.43
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $69.18 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $25.70 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $28.18 / $38.02