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California rates for HCPCS A4377

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

Facilitymedian $3 · 10th–90th $2$80%20%10th90th$3Professionalmedian $3 · 10th–90th $2$230%20%10th90th$3$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $26.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.02 / $22.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.82 / $7.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.16 / $8.71
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $8.32 / $12.59
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $10.96 / $22.39
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.47 / $3.63 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $3.98
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $6.76 / $8.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.50 / $10.00
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $44.67
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.78 / $5.62 / $7.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $5.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $4.90 / $5.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $2.29 / $2.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.69 / $6.46