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Alaska rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Facilitymedian $4 · 10th–90th $2–$60%20%40%10th90th$4Professionalmedian $4 · 10th–90th $1–$90%10%10th90th$4$1.0$2.0$5.0$10.0$20.0$50.0

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
$1.00 / $3.02 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $7.08
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $5.75 / $6.17
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.89 / $19.95
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.89 / $5.89
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $5.89 / $6.17
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $6.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $4.47 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.04 / $2.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.95 / $3.02 / $12.30